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Medical Center Tower I 7950 Floyd Curl Drive Suite 803 San Antonio, TX 78229 tel: 210-615-9500 fax: 210-615-9600 email: office at cecst.com |
Specializing in the compassionate care of people who suffer from abnormalities of the electrical system of the heart |
Current Insurance Plans:
We accept most major commercial insurance plans. Please call for details. Medicare: We have opted out of Medicare, and are happy to care for Medicare beneficiaries on an affordable cash basis. Note: Federal law prohibits signing the Federally-mandated opt-out contract with a Medicare beneficiary who is in an emergency situation. No insurance? No problem! Consider our affordable Fee for service (direct pay). Home of the Original Personalized Medical Office SystemTM released April 5, 2013 |
| Table of Contents |
| Parasystole | |
| The rhythm that results from intermittent capture of the ventricle by a ventricular focus that has entrance block. That is, it is not depolarized when the remainder of the ventricle is activated. The rhythm is characterized by premature ventricular complexes with variable coupling intervals (intervals from the preceding normal QRS complex to the premature complex) and with constant intervals between the premature complexes. Detection of the latter constancy usually requires finding the least common denominator of the intervals between premature complexes, because of the intermittency of ventricular capture by the focus. This rhythm is rare. It is usually considered benign, although any premature ventricular activation can induce malignant ventricular rhythms in the ischemic myocardium or in the presence of a suitable myocardial subtrate. | |
| Quadrigeminy | |
| An abnormal but usually harmless rhythm characterized by occurrence of one ventricular premature complex (VPC) after every three normal QRS complexes. This rhythm usually does not progress to dangerous forms of fast ventricular rhythms. Note that in this rhythm, two VPCs never occur one right after the other. | |
| Reciprocal complex | |
| A QRS complex that is caused by activation of a reentrant circuit rather than by the sinus node. This can be harbinger of atrioventricular nodal tachycardia or atrioventricular tachycardia. | |
| Retrograde atrial activation. | |
| A P wave that occurs because of activation of a portion of the heart below the sinus node, including elsewhere in the atrium, the atrioventricular node (via the fast or a slow AV nodal pathway) or the ventricle (via an accessory pathway). Retrograde P waves typically are inverted in the inferior and right precordial ECG leads (II, III, aVF, and V1), in which the normal sinus P wave is upright. | |
| Sinus tachycardia | |
| This rhythm differs from normal sinus rhythm only in that the rate is above 100 beats per minute. The differential diagnosis is extensive. Common causes are anxiety; physiological stress such as hemorrhage, dehydration, sepsis, and fever; and hyperthyroidism. Correction of the underlying cause, if necessary, is recommended. | |
| Sinus bradycardia | |
| This rhythm differs from normal sinus rhythm only in that the rate is below 60 beats per minute (bpm). This can be a normal finding in young patients, particularly in athletes. It can be caused by medications, including as beta blockers, some calcium blockers such as diltiazem, aldomet, and perhaps digitalis. If there is any concern about this rhythm, consultation with a Cardiologist is recommended. | |
| Sinus arrhythmia | |
| This rhythm is usually a benign finding. It is characterized by variations in the heart rate from cycle to cycle that are greater than would be expected from normal respiratory variation. When pronounced, it can be symptomatic. If there is any concern about this rhythm, consultation with a Cardiologist is recommended. | |
| Sinus arrest | |
| This rhythm results from failure of the sinus node to activate the atria. When it is of short duration (less than one to two seconds), it is usually benign. When it is of long duration (greater than or equal to three seconds), it can be life-threatening because of the potential for longer periods of sinus arrest with asystole. It can be caused by medications, including as beta blockers, some calcium blockers such as diltiazem, aldomet, and perhaps digitalis. It can also be part of the sick sinus ("tachy-brady") syndrome, which is one of the leading indications for implantation of permanent pacemakers in this country. If there is any concern about this rhythm, consultation with a Cardiologist is recommended. | |
| Supraventricular tachycardia. | |
| This is a generic name for a variety of specific supraventricular rhythms, including Atrioventricular Reentrant Tachycardia, Atrioventricular Nodal Reentrant Tachycardia, and Atrial Tachycardia. It is also used in reference to any narrow complex rhythm to distinguish it from wide-complex rhythms that could arise in the ventricle. In addition to the specific rhythms mentioned above, this use of the term includes atrial fibrillation, atrial flutter, junctional tachycardia, accelerated junctional rhythm, and multifocal atrial tachcyardia. | |
| Trigeminy | |
| An abnormal but usually harmless rhythm characterized by occurrence of one ventricular premature complex (VPC) after every two normal QRS complexes. This rhythm usually does not progress to dangerous forms of fast ventricular rhythms. Note that in this rhythm, two VPCs never occur one right after the other. | |
| Ventricular escape complex | |
| This is a QRS that is wide and occurs later than would be expected from the sinus rate. Like all escape complexes, it can occur only when the normal cardiac pacemaker does not function, as is sinus arrest. | |
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