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 ca rd io te x t 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 vo lum es in the series, p lease v is it 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 o f Medicine Massachusetts General Hospital Professor o f Pharmacology and Experimental Therapeutics Harvard Medical School Boston University School o f 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, M S Instructor in Medicine Cardiology Division Massachusetts General Hospital Harvard Medical School e cardiotext. Boston, Massachusetts PUBLISHING Minneapolis, Minnesota © 2015 Philip Podrid, Rajeev Malhotra, Rahul Kakkar, and Peter A. Noseworthy Due to ongoing research, discoveries, modifications to medicines, equipment and devices, and changes in government regulations, the information contained in this book Cardiotext Publishing, LLC may not reflect the latest standards, developments, guidelines, regulations, products or 3405 W. 44th Street devices in the field. Readers are responsible for keeping up to date with the latest Minneapolis, M innesota, 55410 developments and are urged to review the latest instructions and warnings for any USA medicine, equipment or medical device. Readers should consult with a specialist or www.cardiotextpublishing.com contact the vendor of any medicine or medical device where appropriate. Additional information or any updates to this book may be found at: Except for the publisher’s website associated with this work, the publisher is not www.cardiotextpublishing.com/podrid-ecg-interpretation-v4-arrhythmias affiliated with and does not sponsor or endorse any websites, organizations or other Comments, inquiries, and requests for bulk sales can be directed to the publisher at: sources of information referred to herein. 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 o f 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, fo r 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 Ja ck Peter A. Noseworthy v Contents Foreword by Roman W. DeSanctis, M D .................................................. ix Foreword by Hein J.J. Wellens, M D .........................................................xi Pre face...................................................................................... xiii Introduction Arrhythmias.............................................................................1 Real-World ECGs: The Cases Core ECGs: 1 -6 2 ..................................................................... 13 In d e x ........................................................................................ 345 Additional cases fo r further study are available in a separate digital edition, Volume 4, Arrhythm ias— Part B: Practice Cases. v i i