Interpretation of the Electrocardiogram in Small Animals

Interpretation of the Electrocardiogram in Small Animals delivers a simplified and accessible approach to electrocardiography interpretation for veterinarians treating dogs and cats. This practical manual covers a comprehensive list of arrhythmias and associated phenomena using an easy-to-follow format, with hundreds of electrocardiograms and ladder diagrams supporting the text.

The book focuses on the clinical applications of electrocardiographic interpretation, with less emphasis on physics and subcellular mechanisms, making the book a useful patient-side resource. Interpretation of the Electrocardiogram in Small Animals offers readers an up-to-date understanding and knowledge of common and rare phenomena alike.

Beginning with a description of the single cardiac cycle as illustrated by surface EKG, the book moves on to describe variations on the P-QRS-T complex that occur in response to chamber enlargement and hypertrophy. Readers will also benefit from the inclusion of:

  • A detailed discussion of aberrancy and its differentiation from ventricular ectopy
  • A thorough exploration of arrhythmias and conduction disorders including escape mechanisms, atrioventricular block, extrasystoles, accelerated rhythms, tachycardias, flutter and fibrillation
  • An examination of pacemaker basics, as well as a few common abnormalities and pacemaker problems, including undersensing, oversensing, and failure to capture

Interpretation of the Electrocardiogram in Small Animals is a convenient, one-stop reference for the interpretation of electrocardiography in small animals for veterinary students, residents, and specialists as well as for small animal general practitioners.

Table of Contents

Main Introduction

Part I: The P-QRS-T: Introduction

Chapter 1 The P-QRS-T: The Basics

Chapter 2 The P-QRS-T: Some Abnormalities

Chapter 3 The P-QRS-T: Trouble

Part II: Aberrancy: Introduction

Chapter 4 Atrial Aberrancy

Chapter 5 Right Bundle Branch Block

1) Left Bundle Branch Block

2) Fascicular Blocks

3) Wide Complex Supraventricular Tachycardia and Interventricular Conduction Disturbances

Part III: Arrhythmias: Introduction

Sinoatrial Arrhythmias: Introduction

4) Sinoatrial Bradyarrhythmias

5) Sinoatrial Block

6) Sick Sinus Syndrome

7) Sinoatrial Tachyarrhyhmias

Atrial Arrhythmias: Introduction

8) Atrial Bradyarrhythmias

9) Atrial Extrasystoles

10) Atrial Tachycardia

11) Bypass-Tract Mediated Supraventricular Tachycardia

12) Atrial Flutter

13) Atrial Fibrillation

Junctional Arrhythmias: Introduction

14) Junctional Bradyarrhythmias

15) Atrioventricular Block

16) Junctional Extrasystoles

17) Junctional Tachycardia

Ventricular Arrhythmias: Introduction

18) Ventricular Bradyarrhythmias

19) Ventricular Extrasystoles

20) Ventricular Tachycardia, Flutter and Fibrillation

Part IV: Pacemakers: Introduction

21) Pacemakers: The Basics

22) Pacemakers: Some Abnormalities

23) Pacemakers: Trouble

Individual Chapter Subsections:

Chapter 1 The P-QRS-T: The Basics

Leads

Waveforms/intervals

Amplitudes

Paper speeds

Mean electrical axis

False poling

Situs Inversus

Chapter 2 The P-QRS-T: Some Abnormalities

P pulmonale/right atrial abnormality

P pseudo-pulmonale

P mitrale/left atrial abnormality

Interratrial conduction defect

P pseudo-mitrale

P biatriale/biatrial abnormality

P pseudo-biatriale

Right ventricular hypertrophy/right axis deviation

Left ventricular hypertrophy/left axis deviation

Biventricular hypertrophy

Horizontal axis

Vertical axis

Indeterminant axis

Early repolarization

Chapter 3 The P-QRS-T: Trouble

P-R segment changes

Q-T segment changes

The prolonged QRS

Hyperkalemia

Hypokalemia

Other changes

calcium

magnesium

Q-Ti prolongation

hypothermia

Digoxin effects

Cushing’s response

S-T segment elevation/depression

myocardial infarction/ischemic changes

Low-voltage QRS

Electrical alternans

Pericarditis

Chapter 4 Atrial Aberrancy

Interatrial/Intra-atrial block

Chung’s phenomenon

Atrial ectopy

Chapter 5 Right Bundle Branch Block

Incomplete right bundle branch block

Ashman’s phenomenon/2nd-in-a-row anomaly

Rate-dependent and intermittent right bundle branch block

Complete right bundle branch block

Chapter 6 Left Bundle Branch Block

Incomplete left bundle branch block

Rate-dependent and intermittent left bundle branch block

Complete left bundle branch block

Chapter 7 Fascicular Blocks

Left anterior fascicular block

Left medial fascicular block

Left posterior fascicular block

Bilateral bundle branch block

Bifascicular block

Masquerading bundle branch block

Trifascicular block

Arborization block

Chapter 8 Wide Complex Supraventricular Tachycardia and Interventricular Conduction Disturbances

Wide complex supraventricular tachycardia

Interventricular conduction disturbances

Chapter 9 Sinoatrial Bradyarrhythmias

Sinus bradycardia

Sinus arrhythmia

Non-phasic sinus arrhythmia

Phasic sinus arrhythmia

Respiratory sinus arrhythmia

Wandering pacemaker

Non-respiratory phasic sinus arrhythmia

Ventriculophasic sinus arrhythmia

Sinus bigeminy

Sinoatrial escape-capture bigeminy

Sinus pause

Sinus arrest

Asystole

Chapter 10 Sinoatrial Block

Type I 2nd degree sinoatrial block

Type II 2nd degree sinoatrial block

Chapter 11 Sick Sinus Syndrome

Overdrive suppression

Sinus nodal dysfunction

Bradycardia variant

Tachycardia-bradycardia variant

Chapter 12 Sinoatrial Tachyarrhythmias

Sinoatrial extrasystoles

Reciprocation

Parasystole

Sinus tachycardia

Sinus nodal reentrant tachycardia

Chapter 13 Atrial Bradyarrhythmias

Atrial escape beats

Atrial escape-capture bigeminy

Atrial escape rhythm

Atrial standstill

Hyperkalemia

Sinoventricular rhythm

Atrial muscular dystrophy

Chapter 14 Atrial Extrasystoles

Atrial premature complexes

Right atrial premature complexes

Left atrial premature complexes

Multifocal atrial premature complexes

Resetting

Resetting with a pause

Interpolation

Atrial bigeminy

Atrial trigeminy

Atrial premature complexes with aberrancy

Supernormal excitation

Non-conducted atrial premature complexes

Atrial fusion

Reciprocation

Parasystole

Chapter 15 Atrial Tachycardia

Accelerated atrial rhythm

Automatic atrial tachycardia

Interratrial reentrant tachycardia

Atrial dissociation

Chapter 16 Bypass-Tract Mediated Supraventricular Tachycardia

Ventricular pre-excitation and accessory pathways

Ventricular fusion

Atrial echo

Atrioventricular reentrant tachycardia

Orthodromic

Antidromic

Chapter 17 Atrial Flutter

Atrial flutter

Type I atrial flutter

typical

reverse typical/atypical

Type II atrial flutter (“true atypical”)

Atrioventricular block

Artifacts

Chapter 18 Atrial fibrillation

Atrial fibrillation

Aberrancy

Ashman’s phenomenon

Ventricular ectopics

Rule of bigeminy

Atrioventricular dissociation

Concealed conduction

Chapter 19 Junctional Bradyarrhythmias

Junctional escape beats

Junctional escape-capture bigeminy

Junctional escape rhythm

Rule of reset

Reciprocation

Junctional dissociation (double junctional rhythms)

Ventriculophasic junctional arrhythmia

Chapter 20 Atrioventricular Block

1st degree atrioventricular block (incomplete atrioventricular block with long P-Ri)

2nd degree atrioventricular block (incomplete atrioventricular block)

Type I 2nd degree atrioventricular block

Low grade

Typical Wenckebach periodicity

Atypical Wenckebach periodicity

2:1 Wenckebach

High grade

Type II 2nd degree atrioventricular block

Low grade

2:1 Mobitz

High grade

Block/acceleration dissociation

Paroxysmal atrioventricular block

3rd degree atrioventricular block (complete atrioventricular block)

Junctional escape

Ventricular escape

Atrioventricular dissociation

Ventriculoatrial block

Exit block

Chapter 21 Junctional Extrasystoles

Junctional premature complexes

Resetting

Resetting with a pause

Interpolation

Junctional bigeminy

Junctional trigeminy

Junctional premature complexes with aberrancy

Non-conducted junctional premature complexes

Concealed conduction

Atrial fusion

Reciprocation

Parasystole

Chapter 22 Junctional Tachycardia

Accelerated junctional rhythm

Isorhythmic dissociation

Accrochage

Synchrony

Automatic junctional tachycardia

Atrioventricular nodal reentrant tachycardia

Orthodromic

Antidromic

Chapter 23 Ventricular Bradyarrhythmias

Ventricular escape beats

Ventricular escape-capture bigeminy

Ventricular escape rhythm

Electromechanical dissociation

Asystole

Chapter 24 Ventricular Extrasystoles

Ventricular premature complexes

Right ventricular premature complexes

Left ventricular premature complexes

Compensatory pause

Compensatory-like pause

Interpolation

Post-extrasystolic aberrancy

Ventricular bigeminy

The Rule of bigeminy

Ventricular trigeminy

Ventricular quadrigeminy and pentageminy

Concealed conduction (“non-conducted ventricular premature complexes”)

Concealed ventricular bigeminy

Concealed ventricular trigeminy

Ventricular fusion

Ventriculoatrial conduction and reciprocation

Atrial fusion

Parasystole

Chapter 25 Ventricular Tachycardia, Flutter and Fibrillation

Accelerated idioventricular rhythm

Atrioventricular dissociation

Isorhythmic dissociation

Accrochage

Synchrony

Ventriculoatrial association and accelerated ventricular rhythm

Polymorphic and bidirectional accelerated idioventricular rhythm

Ventricular tachycardia

Left ventricular tachycardia

Fascicular ventricular tachycardia

Bidirectional ventricular tachycardia

Right ventricular tachycardia

Right ventricular outflow tract tachycardia

Bundle branch reentrant ventricular tachycardia

Ventriculoatrial block

Double tachycardia

Polymorphic ventricular tachycardia

Torsades de pointes

Ventricular flutter

Ventricular fibrillo-flutter/ventricular dissociation

Ventricular fibrillation

Chapter 26 Pacemakers: The Basics

Indications

Unipolar vs. bipolar

Modes

Endocardial/transvenous vs. epicardial leads

MEA of the paced QRS

Chapter 27 Pacemakers: Some Abnormalities

Concealed conduction

VA conduction

Paced fusion complexes

Paced pseudofusion complexes

Paced reciprocal complexes

Chapter 28 Pacemakers: Trouble

Undersensing

Oversensing

Failure to capture

Battery depletion

Pacemaker-mediated tachycardia

Pacemaker syndrome

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