Emeritus Associate Professor, Department of Medicine, Division
of Cardiology, University of Cape Town, South Africa
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The ECG diagnosis of arrhythmias causes more
problems to the average practitioner than patterns, such as
myocardial infarction or hypertrophy.
I have been involved in the investigation and treatment of
cardiac arrhythmias for more than 40 years. I have taught ECGs
to students, general practitioners, anaesthetists, emergency
room doctors, physicians and cardiologists. This Atlas contains
ECGs of all the common, and most of the uncommon, cardiac
Around 95 ECGs are reproduced full size, as you would see them
at the bedside. Each is followed by detailed analysis on the
opposite page. The spiral binding allows you to examine the ECG
independently before reading my interpretation. The last 20 form
a quiz to allow you to test your skills.
My approach concentrates on making basic observations (rate,
regularity and QRS duration), followed by detailed analysis and
consideration of the possible underlying mechanisms before
coming to a conclusion, and avoiding snap judgements as to the
likely rhythm. All the more difficult diagnoses have been
validated, usually by invasive electrophysiological studies.
The ECGs are grouped into categories:
• Bradycardias and conduction disturbances
• Abnormal rhythms at normal rates
• Narrow QRS tachycardias
• Wide QRS tachycardias
There is an introductory chapter: "Guide to the ECG analysis of
rhythm". Each section is preceded by a text outlining the
approach to that group. A final chapter deals with the benefits
and pitfalls of computers in respect of ECGs.
This is not a textbook or reference work. My aim is to encourage
learning by doing and to instil the habit of systematic analysis
of the ECG, bolstered by knowledge of the possible mechanisms
underlying the observed abnormalities.
The ECG Atlas of Cardiac Rhythms is proudly published by
Clinics Cardive Publishing publishers of the
Cardiovascular Journal of Africa.