General Introduction, Classification, and Electrocardiographic Diagnosis of Cardiac Arrhythmias

Luigi Padeletti; Giuseppe Bagliani

doi:10.1016/j.ccep.2017.05.009

General Introduction, Classification, and Electrocardiographic Diagnosis of Cardiac Arrhythmias

Card Electrophysiol Clin. 2017 Sep;9(3):345-363. doi: 10.1016/j.ccep.2017.05.009. Epub 2017 Jul 14.

Authors

Luigi Padeletti¹, Giuseppe Bagliani²

Affiliations

¹ Heart and Vessels Department, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy; IRCCS Multimedica, Cardiology Department, Via Milanese, 300, 20099 Sesto San Giovanni, Italy.
² Arrhythmology Unit, Cardiology Department, Foligno General Hospital, Via Massimo Arcamone, 06034 Foligno (PG), Italy; Cardiovascular Diseases Department, University of Perugia, Piazza Menghini 1, 06129 Perugia, Italy. Electronic address: giuseppe.bagliani@tim.it.

PMID: 28838545
DOI: 10.1016/j.ccep.2017.05.009

Abstract

The conduction system includes a primary pacemaker, the internodal tracts, the atrioventricular node, and the His bundle with the right and left branches. In "emergency" conditions, accessory pacemakers may be triggered. The conduction system produces very low-intensity currents; a surface electrocardiogram (ECG) detects only the big myocardial masses. Electrogenetic mechanisms are reduced automaticity and/or impaired conduction at the base of bradycardias. An increased automaticity and/or reentry phenomenon are at the base of ectopic beats and tachycardias. A "wide QRS" is a ventricular activation time of 120 milliseconds or more. The "laddergram" helps in the fast and reliable ECG interpretation.

Keywords: Cardiac arrhythmias diagnosis; Cardiac electrophysiology; Electrocardiogram; Laddergram; Normal heart rhythm.

Publication types

Review

MeSH terms

Arrhythmias, Cardiac / diagnosis*
Arrhythmias, Cardiac / physiopathology
Electrocardiography*
Electrophysiologic Techniques, Cardiac*
Heart Conduction System / physiology
Heart Conduction System / physiopathology
Humans