ACC lijst met ECG afwijkingen

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Onderstaande lijst is opgesteld door het American College of Cardiology en bevat alle items, waarin een professional die met ecg's werkt, thuis moet zijn. [1] De ACC heeft ook 2 richtlijnen met adviezen over de technische aspecten van het ecg. [2] [3]

Electrocardiographic Diagnoses

NORMAL TRACING

  1. Normal

ECG TECHNICAL PROBLEMS

  1. Leads misplaced
  2. Artifact

SINUS NODE RHYTHMS AND ARRHYTHMIAS

  1. Sinus rhythm
  2. Sinus tachycardia (>100 beats per minute)
  3. Sinus bradycardia (<50 beats per minute)
  4. Sinus arrhythmia
  5. Sinus arrest or pause
  6. Sino-atrial exit block

OTHER SUPRAVENTRICULAR RHYTHMS

  1. Atrial premature complexes
  2. Atrial premature complexes, nonconducted
  3. Ectopic atrial rhythm
  4. Ectopic atrial tachycardia, unifocal
  5. Ectopic atrial tachycardia, multifocal
  6. Atrial fibrillation
  7. Atrial flutter
  8. Junctional premature complexes
  9. Junctional escape complexes or rhythm
  10. Accelerated junctional rhythm
  11. Junctional tachycardia, automatic
  12. Supraventricular tachycardia, paroxysmal

VENTRICULAR ARRHYTHMIAS

  1. Ventricular premature complexes
  2. Ventricular escape complexes or rhythm
  3. Accelerated idioventricular rhythm
  4. Ventricular tachycardia
  5. Ventricular tachycardia, polymorphous (including torsade de pointes)
  6. Ventricular fibrillation

ATRIALVENTRICULAR CONDUCTION.

  1. First-degree AV block
  2. Mobitz Type 1 second-degree indeterminate) AV block (Wenckebach) 71. Right ventricular infarction (acute)
  3. Mobitz Type 2 second-degree AV block
  4. AV block or conduction ratio, 2:1
  5. AV block, varying conduction ratio
  6. AV block, advanced (high-grade)
  7. AV block, complete (third-degree)
  8. AV dissociation

INTRAVENTRICULAR CONDUCTION

  1. Left bundle branch block (fixed or intermittent)
  2. Right bundle branch block (fixed or intermittent, complete or incomplete)
  3. Intraventricular conduction delay, nonspecific
  4. Aberrant conduction of supraventricular beats
  5. Left anterior fascicular block
  6. Left posterior fascicular block ventricular
  7. Ventricular pre-excitation (Wolff- Failure of appropriate pacemaker Parkinson-White pattern)

QRS AXIS AND VOLTAGE

  1. Right axis deviation (+90 to +180 degrees)
  2. Left axis deviation (-30 to -90 degrees)
  3. Indeterminate axis
  4. Electrical alternans
  5. Low voltage (<0.5 mV total QRS amplitude in Each extremity lead and <1.0 mV in each Precordial lead)

CHAMBER HYPERTROPHY OR ENLARGEMENT

  1. Left atrial enlargement, abnormality, or conduction defect
  2. Right atrial abnormality
  3. Left ventricular hypertrophy (QRS abnormality only)
  4. Left ventricular hypertrophy with secondary ST-T Abnormality
  5. Right ventricular hypertrophy with or without secondary ST-T abnormality

REPOLARIZATION (ST-T,U) ABNORMALITIES

  1. Early repolarization (normal variant)
  2. Juvenile T waves (normal variant)
  3. Nonspecific abnormality, ST segment and/or T wave
  4. ST and/or T wave suggests ischemia
  5. ST suggests injury
  6. ST suggests ventricular aneurysm
  7. Q-T interval prolonged
  8. Prominent U waves

MYOCARDIAL INFARCTION

  1. Inferior MI (acute or recent)
  2. Inferior MI (old or age indeterminate)
  3. Posterior MI (acute or recent)
  4. Posterior MI (old or age indeterminate)
  5. Septal MI (acute or recent)
  6. Anterior MI (acute or recent)
  7. Anterior MI (old or age indeterminate)
  8. Lateral MI (acute or recent)
  9. Lateral MI (old or age indeterminate)
  10. Right ventricular infarction (acute)

CLINICAL DISORDERS

  1. Chronic pulmonary disease pattern
  2. Acute pericarditis
  3. Suggests hypokalemia
  4. Suggests hyperkalemia
  5. Suggests hypocalcemia
  6. Suggests hypercalcemia
  7. Suggests CNS disease

PACEMAKER

  1. Atrial-paced rhythm
  2. Ventricular-paced rhythm
  3. Atrial-sensed ventricular-paced rhythm
  4. AV dual-paced rhythm
  5. Failure of appropriate capture, atrial
  6. Failure of appropriate capture, ventricular
  7. Failure of appropriate inhibition, atrial
  8. Failure of appropriate inhibition, ventricular
  9. Failure of appropriate pacemaker firing
  10. Retrograde atrial activation.
  11. Pacemaker mediated tachycardia

Referenties

  1. Kadish AH, Buxton AE, Kennedy HL, Knight BP, Mason JW, Schuger CD, Tracy CM, Winters WL Jr, Boone AW, Elnicki M, Hirshfeld JW Jr, Lorell BH, Rodgers GP, Tracy CM, Weitz HH, American College of Cardiology/American Heart Association/American College of Physicians-American Society of Internal Medicine Task Force., and International Society for Holter and Noninvasive Electrocardiology.. ACC/AHA clinical competence statement on electrocardiography and ambulatory electrocardiography: A report of the ACC/AHA/ACP-ASIM task force on clinical competence (ACC/AHA Committee to develop a clinical competence statement on electrocardiography and ambulatory electrocardiography) endorsed by the International Society for Holter and noninvasive electrocardiology. Circulation. 2001 Dec 18;104(25):3169-78. PubMed ID:11748119 | HubMed [ACCECG]
  2. Kligfield P, Gettes LS, Bailey JJ, Childers R, Deal BJ, Hancock EW, van Herpen G, Kors JA, Macfarlane P, Mirvis DM, Pahlm O, Rautaharju P, Wagner GS, American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology., American College of Cardiology Foundation., Heart Rhythm Society., Josephson M, Mason JW, Okin P, Surawicz B, and Wellens H. Recommendations for the standardization and interpretation of the electrocardiogram: part I: The electrocardiogram and its technology: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: endorsed by the International Society for Computerized Electrocardiology. Circulation. 2007 Mar 13;115(10):1306-24. DOI:10.1161/CIRCULATIONAHA.106.180200 | PubMed ID:17322457 | HubMed [ACCtech1]
  3. Mason JW, Hancock EW, Gettes LS, American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology., American College of Cardiology Foundation., Heart Rhythm Society., Bailey JJ, Childers R, Deal BJ, Josephson M, Kligfield P, Kors JA, Macfarlane P, Pahlm O, Mirvis DM, Okin P, Rautaharju P, Surawicz B, van Herpen G, Wagner GS, and Wellens H. Recommendations for the standardization and interpretation of the electrocardiogram: part II: Electrocardiography diagnostic statement list: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: endorsed by the International Society for Computerized Electrocardiology. Circulation. 2007 Mar 13;115(10):1325-32. DOI:10.1161/CIRCULATIONAHA.106.180201 | PubMed ID:17322456 | HubMed [ACCtech2]

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