www.realworldECGs.com Podrid’s Real-World A Master’s Approach to the Art and Practice of Clinical ECG Interpretation Volume 4 Arrhythmias— Part A: Core Cases Philip Podrid, MD Rajeev Malhotra, MD, MS Rahul Kakkar, MD • Peter A. Noseworthy, MD www.medilibros.com Forewords by: Hein J.J.Wellens,MD - Roman W.DeSanctis, MD cardiotext Podrid’s Real-World ECGs A Master’s Approach to the Art and Practice of Clinical ECG Interpretation Volume 4 Arrhythmias— Part A: Core Cases Podrid’s Real-World ECGs— The Complete Series Podrid’s Real-World ECGs: A Master’s Approach to the Art and Practice of Clinical ECG Interpretation Volume 1 The Basics Volume 2 Myocardial Abnormalities Volume 3 Conduction Abnormalities Volume 4 Arrhythmias Part A: Core Cases Part B: Practice Cases Volume 5 Narrow and Wide Complex Tachycardias Part A: Core Cases Part B: Practice Cases Volume 6 Paced Rhythms, Congenital Abnormalities, Electrolyte Disturbances, and More For more information about the other volumes in the series, please visit realworldECGs.com. Podrid’s Real-World ECGs A Master’s Approach to the Art and Practice of Clinical ECG Interpretation Volume 4 Arrhythmias— Part A: Core Cases Philip Podrid, MD Rahul Kakkar, MD Professor of Medicine Massachusetts General Hospital Professor of Pharmacology and Experimental Therapeutics Harvard Medical School Boston University School of Medicine Boston, Massachusetts Lecturer in Medicine Harvard Medical School Peter A. Noseworthy, MD Boston, Massachusetts Massachusetts General Hospital Attending Physician Harvard Medical School West Roxbury VA Hospital Boston, Massachusetts West Roxbury, Massachusetts Rajeev Malhotra, MD, MS Instructor in Medicine Cardiology Division Massachusetts General Hospital e cardiotext. Harvard Medical School Boston, Massachusetts PUBLISHING Minneapolis, Minnesota © 2015 Philip Podrid, Rajeev Malhotra, Rahul Kakkar, and Peter A. 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All trademarks, service marks, and trade names used herein are the property of their Unless otherwise stated, all figures and tables in this book are used courtesy respective owners and are used only to identify the products or services of those owners. of the authors. This book is intended for educational purposes and to further general scientific and Cover design by Caitlin Altobell and Elizabeth Edwards; medical knowledge, research, and understanding of the conditions and associated interior design by Elizabeth Edwards 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 Library of Congress Control Number: 2014952877 for a particular condition or a particular patient. It is the reader’s responsibility to ISBN: 978-1-935395-02-7 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. These workbooks are dedicated first to my wife Vivian and son Joshua, whose patience, tolerance, support, and love over the years have been limitless, exceptional, and inspirational. They are also dedicated to the many cardiology fellows, house staff, and medical students whom I have had the pleasure and honor of teaching over the past three decades and who have also taught me so very much. Philip Podrid To my wife Cindy, daughter Sapna, and son Sanjay, for all their love, support, and encouragement. Rajeev Malhotra To my darling daughters, Mia and Eila, whom I love to infinity. Rahul Kakkar For Katie and Jack Peter A. Noseworthy v Contents Foreword by Roman W. DeSanctis, MD..................................................ix Foreword by Hein J.J. Wellens, M D .........................................................xi Preface......................................................................................xiii Introduction Arrhythmias.............................................................................1 Real-World ECGs: The Cases Core ECGs: 1-62.....................................................................13 Index........................................................................................345 Additional cases for further study are available in a separate digital edition, Volume 4, Arrhythmias— Part B: Practice Cases. vii