ECG BASICS- CONDUCTION TISSUE

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ECG Basics-Conduction tissue within Heart and
disorders

• Dr. Md.Toufiqur Rahman
• MBBS, FCPS, MD, FACC, FESC, FRCP,
• FSCAI, FAPSIC, FAPSC
• Associate Professor of Cardiology
• National Institute of Cardiovascular Diseases
• Sher-e-Bangla Nagar, Dhaka-1207

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Dr. Md.Toufiqur Rahman MBBS, FCPS, MD,FACC,
FESC, FRCP, FSCAI, FAPSIC, FAPSC
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Conduction Tissue
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Normal Rhythm ECG
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Leads of ECG
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Precordial Leads
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Pathology of conduction tissue
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Sinoatrial block
Sinus rhythm for three beats, then a 'sinus
pause' P waves arrowed The expected P wave is
not seen, but the SA node must have
beendepolarized because the next P wave appears
at the predicted time
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First degree block
Sinus rhythm PR interval is constant (360 ms)
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Second degree block (Mobitz type 2)
Sinus rhythm with a normal PR interval One P
wave (arrowed) is not followed by a QRS complex
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Second degree block (Wenckebach)
Three beats with progressively longer PR
intervals are followed by a non-conducted P wave
(arrowed) The next PR interval is short, but
this is followed by a longer PR interval and then
another non-conducted beat
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Second degree block (21)
The conducted beats have a normal PR interval
Alternate P waves are not followed by a QRS
complex
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Complete (third degree) block
No relationship between P waves (arrowed) and
QRS complexes The QRS complexes are normal,
indicating that the origin of ventricular
depolarization is within the His bundle The
ventricular rate is 30/min
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Complete (third Degree) block
No relationship between P waves (arrowed) and
QRS complexes Wide QRS complexes Ventricular
rate of 22/min
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