Welch Allyn Means ECG Physicians Manual for CP Series Electrocardiographs - User Manual - Manual (Page 3)

MEANS Physicians Manual
Welch Allyn
3
Contents
1 INTRODUCTION ................................................................................................................................... 4
1.1 Signal conditioning ............................................................................................................................... 4
1.2 Pattern recognition ............................................................................................................................... 5
1.3 Parameter extraction ............................................................................................................................ 5
1.4 Diagnostic classification ....................................................................................................................... 6
1.5 Outline of the manual ........................................................................................................................... 6
1.6 References ........................................................................................................................................... 7
2 CONTOUR ANALYSIS .......................................................................................................................... 8
2.1 Contour parameters ............................................................................................................................. 8
2.2 Dextrocardia and arm electrodes reversal.......................................................................................... 10
2.3 Wolf-Parkinson-White syndrome (WPW) ........................................................................................... 10
2.4 Left Bundle Branch Block (LBBB) ...................................................................................................... 11
2.5 Right Bundle Branch Block (RBBB).................................................................................................... 12
2.6 Incomplete Right Bundle Branch Block (IRBBB) ................................................................................ 13
2.7 Intraventricular conduction delay (IVCD) ............................................................................................ 13
2.8 Atrial overload .................................................................................................................................... 14
2.9 Atrial abnormalities ............................................................................................................................. 14
2.10 Axis deviations and fascicular blocks ................................................................................................. 15
2.11 Low QRS voltage ................................................................................................................................ 16
2.12 QT abnormalities ................................................................................................................................ 16
2.13 Left ventricular hypertrophy (LVH) ...................................................................................................... 17
2.14 Right ventricular hypertrophy.............................................................................................................. 18
2.15 Infarction ............................................................................................................................................. 19
2.16 Pulmonary disease ............................................................................................................................. 25
2.17 ST elevation ....................................................................................................................................... 25
2.18 ST and T abnormalities ...................................................................................................................... 26
2.19 Repolarization .................................................................................................................................... 27
2.20 Miscellaneous ..................................................................................................................................... 28
2.21 Interaction of statements .................................................................................................................... 29
2.22 Combination of statements ................................................................................................................. 31
3 RHYTHM ANALYSIS ........................................................................................................................... 32
3.1 Introduction ......................................................................................................................................... 32
3.2 Rhythm parameters ............................................................................................................................ 33
3.3 Decision tree ...................................................................................................................................... 34
3.4 Group 1: Rhythms with artificial pacemaker spikes ............................................................................ 37
3.5 Group 2: Non-dominant QRS complexes ........................................................................................... 37
3.6 Group 3: Rhythms with atrial flutter or tachycardia ............................................................................. 43
3.7 Group 4: Regular rhythms with P/QRS

0.15 .................................................................................... 44
3.8 Group 5: Regular rhythms with 0.15<P/QRS

1.0 and PR range > 60 ms .......................................... 45
3.9 Group 6: Regular rhythms with P/QRS > 1.0 and PR range

30 ms ................................................. 46
3.10 Group 7: Regular rhythms with P/QRS > 1.0 and PR range > 30 ms................................................. 47
3.11 Group 8: Irregular rhythms with P/QRS

0.15 ................................................................................... 48
3.12 Group 9: Rhythms with paroxysmal acceleration or deceleration of ventricular rate ......................... 48
3.13 Group 10: Irregular rhythms with 0.15 < P/QRS

0.9 and PR range

30 ms ................................... 49
3.14 Group 11: Irregular rhythms with 0.15 < P/QRS

0.9 and PR range > 30 ms ................................... 50
3.15 Group 12: Irregular rhythms with 0.9 < P/QRS

1.2 and PR range > 30 ms ..................................... 51
3.16 Group 13: Irregular rhythms with P/QRS > 1.2 and PR range > 30 ms .............................................. 51
3.17 Group 14: Irregular rhythms with P/QRS > 1.0 and PR range

30 ms .............................................. 52
3.18 Group 15: Rhythms with constant PR interval .................................................................................... 53
4 STATEMENT INDEX ........................................................................................................................... 55
5 THE PERFORMANCE OF MEANS ..................................................................................................... 60