Try Basic Arrythmias by Walreaven.

Also if a local hospital has a cardiac rehab facility contact them and see if they will help you out some.

I had my cardiac test a few weeks ago didn't do well but went and got some tutouring and worked on the book and has helped a great deal

Kat

A 3D RECONSTRUCTION OF THE CONDUCTING SYSTEM OF HEART

Understanding the Electrical Problem in Atrial Fibrillation


In AF, the heart’s electrical signals don’t begin in the SA node. Instead, they begin in another part of the atria or in the nearby pulmonary veins. The signals don’t travel normally. They may spread throughout the atria in a rapid, disorganized way. This can cause the atria to fibrillate.


The faulty signals flood the AV node with electrical impulses. As a result, the ventricles also begin to beat very fast. However, the AV node can’t send the signals to the ventricles as fast as they arrive. So, even though the ventricles are beating faster than normal, they aren’t beating as fast as the atria.


Thus, the atria and ventricles no longer beat in a coordinated way. This creates a fast and irregular heart rhythm. In AF, the ventricles may beat 100 to 175 times a minute, in contrast to the normal rate of 60 to 100 beats a minute.


If this happens, blood isn’t pumped into the ventricles as well as it should be. Also, the amount of blood pumped out of the ventricles to the body is based on the random atrial beats.


The body may get rapid, small amounts of blood and occasional larger amounts of blood. The amount will depend on how much blood has flowed from the atria to the ventricles with each beat.


Most of the symptoms of AF are related to how fast the heart is beating. If medicines or age slow the heart rate, the symptoms are minimized.


AF may be brief, with symptoms that come and go and end on their own. Or, the condition may be ongoing and require treatment. Sometimes AF is permanent, and medicines or other treatments can’t restore a normal heart rhythm.


The animation below shows atrial fibrillation. Click the “start” button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.


 

What Causes Atrial Fibrillation?


Atrial fibrillation (AF) occurs if the heart’s electrical signals don’t travel through the heart in a normal way. Instead, they become very rapid and disorganized.


Damage to the heart’s electrical system causes AF. The damage most often is the result of other conditions that affect the health of the heart, such as high blood pressure and coronary heart disease.


The risk of AF increases as you age. Inflammation also is thought to play a role in causing AF.


Sometimes, the cause of AF is unknown.


What Are the Signs and Symptoms of Atrial Fibrillation?


Atrial fibrillation (AF) usually causes the heart’s lower chambers, the ventricles, to contract faster than normal.


When this happens, the ventricles can’t completely fill with blood. Thus, they may not be able to pump enough blood to the lungs and body. This can lead to signs and symptoms, such as:


► Palpitations (feelings that your heart is skipping a beat, fluttering, or beating too hard or fast)

► Shortness of breath

► Weakness or problems exercising

► Chest pain

► Dizziness or fainting

► Fatigue (tiredness)

► Confusion


 

ECG CHANGES IN LEFT VENTRICULAR HYPERTROPHY ::

• Left ventricular hypertrophy produces an abnormally prominent R wave in left precordial leads, along with features of Left Axis deviation.

 • Tall peaked R waves are seen in Left precordial leads -- V4 - V6

Abnormally deep S waves in leads V2 - V3

 • Features of Left Axis deviation can be found in standard limb leads

• Ventricular strain :: Due to hypertrophy of ventricles, the repolarization changes occur, leading to repolarization to occur from endocardium --> epicardium instead of

epicardium --> endocardium (normal)

Diagnostic criteria of LVH ::

 Sokolov - Lyon criteria :: S wave depth in V1 + tallest R wave height in V5-V6 > 35 mm

 

Other diagnostic criteria are also used.

Image :: ECG with left ventricular hypertrophy

-->Markedly increased LV voltages: S wave in V1 + R wave in V6 > 35 mm; R wave in aVL > 11 mm.

 -->Increased R wave peak time: the upstroke of the QRS complex is slurred in V5-6, resulting in minor QRS broadening.

 -->Left ventricular strain pattern: T wave inversion in the lateral leads V5-6, I and aVL.

 -->Left axis deviation.

 -->Signs of left atrial enlargement.

 — with Saikat Bera and Vincent Omoregbe.

Simplified one: ECG CHANGES IN RVH

 

Right ventricular hypertrophy occurs mainly in lung disease or in congenital heart disease. The ECG shows a negative QRS complex in I (and thus a right heart axis) and a positive QRS complex in V1.

 

• QRS duration < 120ms

 • Right heart axis (> 110 degrees)

 • Dominant R wave:

 R/S ratio in V1 or V3R > 1, or R/S ratio in V5 or V6 <= 1

 R wave in V1 >= 7 mm

 R wave in V1 + S wave in V5 or V6 > 10.5 mm

 • rSR= in V1 with R'= > 10 mm

 • qR complex in V1

 • Secondary ST-T changes in right precordial leads

 • Right atrial abnormality

 • Onset of intrinsicoid deflection in V1 between 0.035 and 0.055 s

 

 ECG CHANGES IN LEFT ATRIAL ENLARGEMENT

-- Left atrium forms the later part of the P wave. Hence enlargement of left atrium will produce an increase in the duration of the P wave, as well as delayed depolarization leading to "Double peaks" in P wave

 -- Also called " P - mitrale "

 -- This is evident very clearly in Chest leads

-- P wave is generally > 120 ms

 Image Below: LAE ... typical "bipeaked " P mitrale

 ECG CHANGES IN RIGHT ATRIAL ENLARGEMENT

 -- Right atrium forms the initial part of the p wave... hence Right atrial enlargement will produce Peaked/Tall P wave, and not widen the duration of P wave.

 -- Refered to as P - pulmonale

 -- Tall peaked P wave is seen in lead II and many leads (especially in right precordial leads)

-- P wave is Pointed

 -- Usually > 2.5 mm

CHAMBER HYPERTROPHIES/ENLARGEMENTS :: (BELOW IMAGE)

 

LEFT ATRIAL ENLARGEMENT

-- Left atrium forms the later part of the P wave. Hence enlargement of left atrium will produce an increase in the duration of the P wave, as well as delayed depolarization leading to "Double peaks" in P wave

 -- Also called " P - mitrale "

 -- This is evident very clearly in Chest leads

-- P wave is generally > 120 ms

 Image Below: LAE ... typical "bipeaked " P mitrale

 LOOK FOR DANGER SIGNS IN PIGMENTED LESIONS(MOLES) OF THE SKIN

 

Consult your Dermatologist if any of the following signs exhibited by your mole, this could indicate your mole is turning to be cancerous.

 

ASYMMETRY

 IRREGULAR BORDER

 COLOR VARIED

 DIAMETER

J POINT ::

-- The J point is the the junction between the termination of the QRS complex and the beginning of the ST segment.

 

Abnormalities with J point ::

 

--Elevation or depression of the J point is seen with the various causes of ST segment abnormality.

 

-- Notching of the J point occurs with benign early repolarisation.

 

-- A positive deflection at the J point is termed a J wave (Osborn wave) and is characteristically seen with hypothermia.