Basic to Advanced ECG Classes available

My name is Jason Winter and I work for a NHS Ambulance service in the UK as a ambulance clinician. I hold a Diploma in Electrocardiography by the Society of Cardiological Science and Technology (SCST) and also I have attended other specialist ECG courses at university level 6 and 7. My classes can be arranged to suit the need of your students. Please send a email for further details. ECG.Educator@gmail.com

Introduction to the 12-lead ECG

TO BE COMPLETED

Bundle Branch Blocks

In BBB, one or the other (or both) of these bundle branches no longer conduct electrical impulses normally. This can occur from disease or damage to one of the bundle branches, or it may occur for no apparent reason in completely healthy people. When the electrical impulse is delayed in reaching its respective ventricle, the delay shows up as a distinctive pattern on the ECG called a BBB. The chief effect of a BBB is to disrupt the normal, coordinated and simultaneous contraction of the two ventricles. The contraction of one ventricle (the one whose bundle branch is blocked) occurs slightly after the contraction of the other.

People with BBB usually will have either right bundle branch block (RBBB) or left bundle branch block (LBBB), depending on which of the two bundle branches is "blocked." Sometimes both bundle branches are affected, and the BBB pattern on the ECG is not clearly identifiable as either right or left BBB - in this case, the BBB is referred to as an intraventricular conduction delay (IVCD).

Wolff-Parkinson-White

Wolff–Parkinson–White syndrome (WPW) is one of several disorders of the electrical system of the heart that are commonly referred to as pre-excitation syndromes.

WPW is caused by the presence of an abnormal accessory electrical conduction pathway between the atria and the ventricles. Electrical signals traveling down this abnormal pathway (known as the bundle of Kent) may stimulate the ventricles to contract prematurely, resulting in a unique type of supraventricular tachycardia referred to as an atrioventricular reciprocating tachycardia.

WPW ECG Examples:

Pacemakers

ECG Training

Hyperkaelemia ECG Features

With mild to moderate hyperkalemia, there is reduction of the size of the P wave and development of peaked T waves. Severe hyperkalemia results in a widening of the QRS complex, and the ECG complex can evolve to a sinusoidal shape. There appears to be a direct effect of elevated potassium on some of the potassium channels that increases their activity and speeds membrane repolarization. Also, (as noted above), hyperkalemia causes an overall membrane depolarization that inactivates many sodium channels. The faster repolarization of the cardiac action potential causes the tenting of the T waves, and the inactivation of sodium channels causes a sluggish conduction of the electrical wave around the heart, which leads to smaller P waves and widening of the QRS comple.

To be completed