ECG Masters’ Collection: Favorite ECGs from Master Teachers Around the World

218 Pages·2018·23.898 MB·English

by  Mohammad Shenasa, Mark E. Josephson, N.A. Mark Estes III, Ezra A. Amsterdam, Melvin Scheinman (editors)

ECG Masters’ Collection F E
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Favorite ECGs from Master Teachers Around the World t
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Editors:
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Mohammad Shenasa, MD • Mark E. Josephson, MD • N. A. Mark Estes III, MD m
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Ezra A. Amsterdam, MD • Melvin Scheinman, MD
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Over 300 exceptional electrocardiogram case studies curated from the libraries of 60 C
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Favorite ECGs from
internationally recognized master teachers of ECG interpretation are brought together r o

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in this one-of-a-kind resource for student and teacher alike. e l
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Presented in two individual volumes and organized by disease type, ECG case h c
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studies are shown in a clinical context followed by questions and discussion. Medical r
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students, residents, fellows, physicians — anyone who is involved in caring for A
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patients with various cardiovascular diseases and other systemic pathologies — will
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n V O L U M E 2
find this unique collection with a global perspective useful and practical in developing
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the skills necessary to read ECGs. t
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Editors:

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This book should serve as an important reference, and I guarantee it will be o
Mohammad Shenasa
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pulled from the shelf for decades to come. d
Mark E. Josephson
–Francis E. Marchlinski, MD
N. A. Mark Estes III
VOL. 2
The collection of ECGs is remarkable. Students of electrocardiography will Ezra A. Amsterdam
enjoy reading this book and teachers will utilize many of its tracings as
Melvin Scheinman
Shenasa
materials for their ECG rounds.
Josephson
–Prof. Jerónimo Farré MD, PhD
Estes
Amsterdam Forewords by
Scheinman
Francis E. Marchlinski
and Samuel Lévy
This book includes a free digital
Volume 1 – 230 ECG case studies.
edition for use by the first buyer.
978-1-942909-08-8
3405 W. 44th Street For additional information regarding
Volume 2 - 79 ECG case studies.
Minneapolis, Minnesota 55410 personal or institutional use, please
978-1-942909-20-0
www.cardiotextpublishing.com visit www.cardiotextpublishing.com.
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ECG Masters’ Collection
Favorite ECGs from Master Teachers
Around the World
Volume 2
Mohammad Shenasa, MD
Mark E. Josephson, MD
N.A. Mark Estes III, MD
Ezra A. Amsterdam, MD
Melvin Scheinman, MD
Minneapolis, Minnesota
© 2018 Mohammad Shenasa, Mark E. Josephson, N.A. Mark Estes III, Ezra A. Amsterdam, Melvin Scheinman
Cardiotext Publishing, LLC
3405 W. 44th Street
Minneapolis, Minnesota 55410
USA
www.cardiotextpublishing.com
Any updates to this book may be found at:
www.cardiotextpublishing.com/electrophysiology-heart-rhythm-mgmt/ecg-masters-collection-volume-2
Comments, inquiries, and requests for bulk sales can be directed to the publisher at: [email protected].
All rights reserved. No part of this book may be reproduced in any form or by any means without the prior
permission of the publisher.
All trademarks, service marks, and trade names used herein are the property of their respective owners and are
used only to identify the products or services of those owners.
This book is intended for educational purposes and to further general scientific and medical knowledge, research,
and understanding of the conditions and associated treatments discussed herein. This book is not intended to
serve as and should not be relied upon as recommending or promoting any specific diagnosis or method of
treatment for a particular condition or a particular patient. It is the reader’s responsibility to determine the proper
steps for diagnosis and the proper course of treatment for any condition or patient, including suitable and
appropriate tests, medications or medical devices to be used for or in conjunction with any diagnosis or
treatment.
Due to ongoing research, discoveries, modifications to medicines, equipment and devices, and changes in
government regulations, the information contained in this book may not reflect the latest standards,
developments, guidelines, regulations, products or devices in the field. Readers are responsible for keeping up to
date with the latest developments and are urged to review the latest instructions and warnings for any medicine,
equipment or medical device. Readers should consult with a specialist or contact the vendor of any medicine or
medical device where appropriate.
Except for the publisher’s website associated with this work, the publisher is not affiliated with and does not
sponsor or endorse any websites, organizations or other sources of information referred to herein.
The publisher and the authors specifically disclaim any damage, liability, or loss incurred, directly or indirectly,
from the use or application of any of the contents of this book.
Unless otherwise stated, all figures and tables in this book are used courtesy of the authors.
Library of Congress Control Number:  2018931463
ISBN: 978-1-942909-20-0
eISBN: 978-1-942909-21-7
Printed in The United States of America
For additional ECG case studies, please consider ECG Masters’ Collection, Volume 1
cardiotextpublishing.com/electrophysiology-heart-rhythm-mgmt/ecg-masters-collection
1 2 3 4 5 6 7 21 20 19 18
Dedication
We dedicate this book in memory of Mark E. Josephson, MD (January 27, 1943 – January 11, 2017),
who inspired and mentored many of us. He gave the electrogram a new look: “ECG as a mapping tool.”
He is also the senior editor on this book.

Contents
Contributors ...........................................................................................................................vii
Forewords ..............................................................................................................................xiii
Dr. Francis E. Marchlinski
Dr. Samuel Lévy
Preface ..................................................................................................................................xvii
Abbreviations ........................................................................................................................xix
Section 1 Introduction to the Interpretation of the Electrocardiogram ...........................1
Section 2 Conduction Disturbances: Sinus Node Disease/Sick Sinus Syndrome,
AV Conduction Disturbances, AV Blocks, Bundle Branch Blocks, and
Fascicular Blocks ...................................................................................................3
Section 3 Miscellaneous Phenomena: Concealed Conduction, Superabnormalities,
Aberrancy Conduction, Premature Atrial and Ventricular
Contractions (PACs and PVCs) ............................................................................33
Section 4 Preexcitation Syndromes ...................................................................................39
Section 5 Early Repolarization (ECG Pattern and the Syndrome) ....................................55
Section 6 Long and Short QT Syndromes ..........................................................................61
A. Long QT Syndrome .......................................................................................61
B. Short QT Syndrome*
C. Torsades de Pointes ......................................................................................63
D. Other Proarrhythmias*
Section 7 Brugada Syndrome .............................................................................................65
Section 8 Narrow QRS Complex Arrhythmias ...................................................................79
A. Inappropriate Sinus Tachycardia*
B. Sinus Node Reentrant Tachycardia*
C. Atrial Tachycardia/Atrial Flutter ...................................................................79
D. Atrioventricular Nodal Reentrant Tachycardia ............................................91
E. Atrioventricular Reentrant Tachycardia*
F. Atrial Fibrillation*
G. Junctional Rhythms ....................................................................................103
* Included only in Volume 1.
v
Section 9 Wide Complex Arrhythmias .............................................................................105
A. Ventricular Tachycardia/Fibrillation ...........................................................105
B. Supraventricular Tachycardia (SVT) with Bundle Branch Block (BBB)*
C. Preexcited Tachycardia ...............................................................................123
D. Idioventricular Rhythm*
Section 10 Ischemia and Infarction ....................................................................................125
Section 11 Electrolyte Disturbances, Pharmacological and Recreational Agents*
Section 12 Paced Rhythms and Device Troubleshooting .................................................129
Section 13 Heart Failure, Left Ventricular Hypertrophy, and Cardiomyopathies ...........149
A. Arrhythmogenic Right Ventricular
Dysplasia/Cardiomyopathy (ARVD/C) .........................................................149
B. Hypertrophic Cardiomyopathy (HCM)*
C. Dilated Cardiomyopathy (DCM)*
D. Chagas*
E. Takotsubo (Stress) Cardiomyopathy*
F. Non-Compaction Cardiomyopathy*
G. Pericarditis ...................................................................................................159
H. Other Cardiomyopathies*
Section 14 Congenital Heart Diseases*
Section 15 Special Considerations: Age, Race, Gender, and Athletes .............................165
Section 16 Syncope and ECG Troubleshooting .................................................................187
Appendix ..............................................................................................................................195
* Included only in Volume 1.
vi u Contents
Contributors
Editors Contributors
Mohammad Shenasa, MD, FACC, FHRS, Ahmed Abdel Aziz, MD, PhD
FAHA, FESC Professor, Critical Care Medicine Department,
Attending Physician, Department of Cairo University Hospitals, Cairo, Egypt
Cardiovascular Services, O’Conner Hospital;
Baris Akdemir, MD
Heart & Rhythm Medical Group, San Jose,
Cardiac Electrophysiology Fellow, Cardiology,
California
University of Minnesota, Minneapolis,
Mark E. Josephson, MD, FACC, FHRS, Minnesota
FAHA
Jason Andrade, BSc, MD, FRCPC, FHRS
Director, Harvard-Thorndike Electrophysiology
Clinical Assistant Professor, Department of
Institute and Arrhythmia Service;
Medicine, University of British Columbia,
Chief Emeritus, Division of Cardiovascular
Vancouver, British Columbia, Canada; Adjunct
Medicine, Beth Israel Deaconess Medical
Professor, Université de Montréal, Clinical
Center; Herman C. Dana Professor of Medicine,
Electrophysiology Service, Montreal Heart
Harvard Medical School, Boston,
Institute, Montreal, Quebec, Canada
Massachusetts
Adrian Baranchuk, MD, FACC, FRCPC, FCCS
N.A. Mark Estes III, MD, FACC, FHRS,
Professor of Medicine (Tenure), Head, Heart
FAHA, FESC
Rhythm Service, Queen’s University, Kingston,
Professor of Medicine, Tufts University School
Ontario, Canada
of Medicine; Director, New England Cardiac
Arrhythmia Center, Tufts Medical Center,
Antoni Bayés de Luna, MD, PhD, FESC, FACC
Boston, Massachusetts
Senior Investigator, Catalan Institute of
Cardiovascular Sciences, St. Pau Hospital,
Ezra A. Amsterdam, MD
Barcelona, Spain
Distinguished Professor, Associate Chief
(academic affairs), Division of Cardiovascular Bernard Belhassen, MD, FHRS
Medicine, University of California, Davis, Department of Cardiology, Tel Aviv Sourasky
Medical Center, Sacramento, California Medical Center; Sackler Faculty of Medicine,
Tel Aviv University, Tel Aviv, Israel
Melvin Scheinman, MD, FACC, FHRS
Professor of Medicine, Walter H. Shorenstein David G. Benditt, MD, FACC, FHRS, FRCPC,
Endowed Chair in Cardiology; Chief of FESC
Cardiology Genetics Arrhythmia Program, Cardiac Arrhythmia Center, Cardiovascular
University of California, San Francisco, Division, University of Minnesota Medical
San Francisco, California School, Minneapolis, Minnesota
vii
Dan Blendea, MD, PhD, FHRS Paolo China, MD
Cardiac Arrhythmia Service, Department of Unit of Electrophysiology and Cardiac
Medicine, Massachusetts General Hospital, Pacing, Ospedale Dell’Angelo,
Boston, Massachusetts Venice, Italy
Maichel Sobhy Naguib Botros, MD, PhD, Jane E. Crosson, MD
ECES Associate Professor of Pediatrics,
EHRA Certified Electrophysiology Specialist Johns Hopkins Hospital, Baltimore, Maryland
Lecturer, Critical Care Medicine Department,
Andrei G. Dan, MD, PhD, FESC, FAHA,
Cairo University Hospital
FACC, FEHRA
Cairo, Egypt 
Head of Cardiology Department and Internal
Medicine Clinic, Colentina University
Jonathan Bui, MD
Hospital; Professor, “Carol Davila” University of
Internal Medicine Resident, 
Medicine, Bucharest, Romania
Billings Clinic, Billings,
Montana
Marc Dubuc, MD, FRCPC, FACC, FHRS
Associate Professor of Medicine, Université de
Haran Burri, MD
Montréal; Clinical Electrophysiology Service,
Associate Professor, Cardiology Department,
Montreal Heart Institute, Montreal,
University Hospital of Geneva,
Quebec, Canada
Geneva, Switzerland
Kenneth A. Ellenbogen, MD, FHRS
Catalin A. Buzea, MD, PhD
Kontos Professor of Medicine, 
Cardiology Consultant, Cardiology
Chair, Division of Cardiology, 
Department, Colentina University Hospital;
Virginia Commonwealth University, 
Associate Professor, “Carol Davila” University
Pauley Heart Center, Richmond, Virginia
of Medicine, Bucharest, Romania
Tamer S. Fahmy, MD, PhD
David J. Callans, MD, FHRS
Associate Professor, Critical Care Medicine
Professor of Medicine, Perelman School of
Department, Cairo University Hospitals,
Medicine; Associate Director of
Cairo, Egypt
Electrophysiology, University of Pennsylvania
Health System, Philadelphia, Pennsylvania Miquel Fiol, MD, PhD
Balearic Islands Health Research Institute
Sanoj Chacko, MD, PhD (IdISBa) and Son Espases Hospital. Palma,
Heart Rhythm Service, Queen’s University, Spain; Physiopathology of Obesity and
Kingston, Ontario, Canada Nutrition Networking Biomedical Research
Centre (CIBERObn), Carlos III Health Institute,
Alan Cheng, MD, FACC, FAHA, FHRS
Madrid, Spain
Adjunct Associate Professor of Medicine,
Adjunct Associate Professor of Pediatrics, Robert Frank, MD
Johns Hopkins University School of Medicine, Institut de Cardiologie, Hopital Pitié
Baltimore, Maryland Salpétrière, Paris, France
viii u Contributors