ECG Workout: Exercises in Arrhythmia Interpretation

763 Pages·2016·216.505 MB·English

by  Jane Huff

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ECG WORKOUT
EXERCISES IN
ARRHYTHMIA
INTERPRETATION
Seventh Edition
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ECG WORKOUT
EXERCISES IN
ARRHYTHMIA
INTERPRETATION
Jane Huff, RN, CCRN
Education Coordinator, Critical Care Unit
Arrhythmia Instructor
Advanced Cardiac Life Support (ACLS) Instructor
Preceptor-Mentor, Critical Care Unit
Unity Health White County Medical Center Searcy, Arkansas
Seventh Edition
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7th edition
Copyright © 2017 Wolters Kluwer
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Printed in China (or the United States of America)
Library of Congress Cataloging-in-Publication Data
Names: Huff, Jane, RN, author.
Title: ECG workout : exercises in arrhythmia interpretation / Jane Huff.
Description: 7th edition. | Philadelphia : Wolters Kluwer, [2017]
Identifiers: LCCN 2016008681 | ISBN 9781469899817 (paperback)
Subjects: | MESH: Arrhythmias, Cardiac—diagnosis | Electrocardiography |
Problems and Exercises
Classification: LCC RC685.A65 | NLM WG 18.2 | DDC 616.1/207547—dc23 LC record available at http://lccn.loc.gov/2016008681
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This work is no substitute for individual patient assessment based upon healthcare professionals’ examination of each patient and consideration
of, among other things, age, weight, gender, current or prior medical conditions, medication history, laboratory data and other factors unique to
the patient. The publisher does not provide medical advice or guidance and this work is merely a reference tool. Healthcare professionals, and
not the publisher, are solely responsible for the use of this work including all medical judgments and for any resulting diagnosis and treatments.
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This book is dedicated to my
heavenly Father for His guidance
and love.
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Preface
ECG Workout: Exercises in Arrhythmia Interpretation, Seventh Edition, was written to assist physicians, nurses,
medical and nursing students, paramedics, emergency medical technicians, telemetry technicians, and other
allied health personnel in acquiring the knowledge and skills essential for identifying basic arrhythmias. It may
also be used as a reference for ECG review for those already knowledgeable in ECG interpretation.
The text is written in a simple manner and illustrated with figures, tables, boxes, and ECG tracings. Each
chapter is designed to build on the knowledge base from the previous chapters so that the beginning student
can quickly understand and grasp the basic concepts of electrocardiography. An effort has been made not only
to provide good quality ECG tracings but also to provide a sufficient number and variety of ECG practice strips
so the learner feels confident in arrhythmia interpretation. There are over 600 practice strips—more than any
book on the market.
Chapter 1 provides a discussion of basic anatomy and physiology of the heart. The electrical basis of
electrocardiology is discussed in Chapter 2. The components of the ECG tracing (waveforms, intervals,
segments, and complexes) are described in Chapter 3. This chapter also includes practice tracings on
waveform identification. Cardiac monitors, lead systems, lead placement, ECG artifacts, and troubleshooting
monitor problems are discussed in Chapter 4.
A step-by-step guide to rhythm strip analysis is provided in Chapter 5, in addition to practice tracings on
rhythm strip analysis. The individual rhythm chapters (Chapters 6 through 9) include a description of each
arrhythmia, arrhythmia examples, causes, and management protocols.
Current advanced cardiac life support (ACLS) guidelines are incorporated into each arrhythmia chapter as
applicable to the rhythm discussion. Each arrhythmia chapter also includes approximately 100 practice strips.
Chapter 10 presents a general discussion of cardiac pacemakers (types, indications, function, pacemaker
terminology, malfunctions, and pacemaker analysis), along with practice tracings. Chapter 11 is a posttest
consisting of a mix of rhythm strips that can be used as a self-evaluation tool or for testing purposes.
The text has been thoughtfully revised and expanded to include new figures, updated boxes and tables,
additional glossary terms, and even more practice rhythm strips. New to this edition, pull-out arrhythmia
summary cards with rhythm strip examples on each arrhythmia group can be found in the back of the book to
use as a guide to interpret the practice strips at the end of each chapter. Skillbuilder rhythm strips appear
immediately following the practice rhythm strips in Chapters 7, 8, and 9. Each Skillbuilder section provides a
mix of strips that test not only your understanding of information learned in that arrhythmia chapter but also
the concepts and skills learned in the chapter(s) immediately preceding it. For example, the Skillbuilder strips
in Chapter 7 (Atrial Arrhythmias) include atrial rhythm strips as well as strips on sinus arrhythmias (covered
in Chapter 6). The skillbuilder strips in Chapter 8 (Junctional Arrhythmias and AV Blocks) include junctional
and AV block strips as well as strips on sinus and atrial arrhythmias. The skillbuilder strips in Chapter 9
(Ventricular Arrhythmias and Bundle-Branch Block) include a mix of all the arrhythmias covered in Chapters
6 through 9. Such practice with mixed strips will enhance your ability to differentiate between rhythm groups
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as you progress through the book—a definite advantage when you get to the posttest. Pull-out flashcards are
included in the back of the book to further challenge your ability to identify different types of arrhythmias.
The ECG tracings included in this book are actual strips from patients. Above each rhythm strip are 3-
second indicators for rapid-rate calculation. For precise rate calculation, an ECG conversion table for heart rate
is printed on the inside back cover. For convenience, a removable plastic version is also attached to the inside
back cover. The heart rates for regular rhythms listed in the answer keys were determined by the precise rate
calculation method and will not always coincide with the rapid-rate calculation method. Rate calculation
methods are discussed in Chapter 5.
The author and publisher have made every attempt to check the content, especially drug dosages and
management protocols, for accuracy. Medicine is continually changing, and the reader has the responsibility
to keep informed of local care protocols and changes in emergency care procedures.
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Contents
Preface
one Anatomy and Physiology of the Heart
two Electrophysiology
three Waveforms, Intervals, Segments, and Complexes
four Cardiac Monitors
five Analyzing a Rhythm Strip
six Sinus Arrhythmias
seven Atrial Arrhythmias
eight Junctional Arrhythmias and AV Blocks
nine Ventricular Arrhythmias and Bundle-Branch Block
ten Pacemakers
eleven Posttest
Answer Key to Chapter 3
Answer Key to Chapters 5 through 11
Glossary
Index
Arrhythmia Summary Pull-Out Section
Arrhythmia Flash Cards Pull-Out Section
Electrocardiographic Conversion Table for Heart Rate
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