Welch Allyn Means ECG Physicians Manual for CP Series Electrocardiographs - User Manual User Manual
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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
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