?.????(premature beat)

1

• ?.????(premature beat)
• ????????????????
• ???????
• ECG?? ???????(???)?
• ??????????????????
• ?????????

2
????premature contraction

• ????????????????
• ???????,????
• ??????????????
• ????????
• ????????????

3
????????

• ????(coupling interval)???????????????
• ????(compensatory pause)????????????????

4

• ???????,????????????
• ?????????????,?????
• ???
• ???????????????????
• ???? ????

5

• ????????????(bigeminy)????(trigeminy)
• ??? 1??1?? 3?
• ??? 2??1???1??2??

6
????premature atrial contraction

• ???????P?,?????P??,P-Rgt0.12?
• QRS????
• ????????
• ??P???QRS-T,??????
• ??P????QRS??,??????????

7

• ?????
• Premature junctional contraction
• ??????-????-??
• ????QRS?????P,P??QRS??,P-Rlt0.12???QRS??,R-P
  lt0.20?,QRS??????????,??P??QRS??
• ??????????

8

• ????
• Premature ventricular contraction
• ECG
• QRS????,?????,
• ??????
• QRS????0.12??
• T?????????
• ????????

9

• ?????
• ???????2?QRS????????
• ???????

10

• ?.???????
• 1 .???????
• (paroxysmal tachycardia)
• ??
• ????,????
• ??????(gt150?/?)
• ??????,???????

11
??????????paroxysmal supraventricular
tachycardia(PSVT)

• ????????????,?P????,???????????
• ????,??????,160-250?/?,QRS???????
• ????????????????????????????

12
??????????

• 3?????????QRS?,??160250?/?
• R-R????
• QRSlt0.1?
• ?P??P????P?

13
?????????ventricular tachycardia

• 3?????????QRS?,??140200?/???
• QRS0.12?,T???????
• R-R?????????P?
• ??????????

14
????????nonparoxysmal tachycardia

• ??????????????,??????????????????
• ?????
• ????????,?????????
• ????70-130?/?,??60-100?/?
• ????????????

15
?????torsade de pointes(TDP)

• ??????310???,QRS????????????????????????
• ????Q-T???T????

16
TDP????

• ????Q-T?????
• ?????????,????????T?
• ??,???????T??U?
• ????(???,???)

17
?.?????

• ????????????????
• ????????????

18
??atrial flutter(AF)

• P?????????250350?,????,??????????(??F?)
• QRS??????
• ????????21,???41?31??
• ?????????????,???????????????????,?????

19
??atrial fibrilation(Af)

• P???,??????????,????,
• ??????????(??f ?),????
• 350600?/?,V1?????
• R-R????,??lt200?/?,QRS???????

20
? ?ventricula fibrilation

• ??QRS-T???,??????????????,??????

21
? ?ventricular flutter

• ??????????QRS-T?,??????????????,??200-250?/?

22
????

• ???????????,???????
• ????
• ????

23
??????heart block

• ???????,??,??,??????
• ???????(????),??(??????????),??(??????)

24
????

• ??????
• II?I???????, P-R????,P-P?????????P-P??,?P-P?????P-
  P????

25
??????

• II?II???????P-R????,P-P????,?????P-P????P-P??2?

26
????intra-atrial block

• P?0.12s,????,????0.04s,V1??Ptf????

27
??????(AVB)atrioventricular block

• ????????????????????
• ?????,??AVB?
• ??
• ????????????
• ?????AMI?
• ??????
• ?????????

28
? ?

• ?????,AVB??????????
• ???AVB ECG???P-R????,gt0.20??
• ???AVB ??P??QRS???,?
• ????

29
??AVB I?

• ??(Morbiz ??)ECG???P-R??????,
• ??QRS??,????P-R??????
• ?,???????,??????(wenckebach phenomenon)?
• PQRS????????,??32?43?54?

30
??AVB II?

• ??(Morbiz ??) ???P-R????(?????), ??P???QRS??
• ??????????QRS????,???AVB,? 31?41AVB?

31
??AVB ?????AVB

• ????????????????????????????????,?????????,??????

32

• ECG??
• P??QRS???,????????
• ???????
• Af?,???????????,????
• ??????AVB ?

33

• ??????
• ???????????????????
• ???????????
• ???? QRS????0.12???????
• ????????

34
???????(RBBB)right bundle branch block

• QRS??0.12?
• V1?V2???QRS???rSR'??
• ???????R?S-T???,
• T?????V5,6??S???
• ??0.04?
• V1,2 ?VAT0.06?
• ST-T???QRS???????
• ??
• ??QRSlt 0.12?,????
• ??RBBB?

35
???????(LBBB)left bundle branch block

• QRS0.12?
• ??V5,6??Q??????,
• R??????????,
• V1,2???QS??r?
• ??,S?????
• V5,6?VAT 0.06?
• ST-T???QRS??????

36
??????(LAFB)left anterior fascicular block

• ???????,-30-90,
• gt-45????
• ????avF?rS?,S???,
• S?gtS?,??avL?qR,
• R avLgtR?
• QRS?????

37
??????(LPFB)left posterior fascicular block

• ????????
• 90120,gt110
• ???
• ?? avL???rS?,
• ????avF???qR
• ?,R?????
• QRS????????,
• ?????lt0.02 ?

38
?????

• ??????????????????????????
• ???????????????????????,???????(interference
  atrioventricular dissociation)

39
?????(preexcitation syndrome)

• ??????????,?????????????????(??).
• WPW???,??????????????????????????????(Kent?)

40
?????A?(????)

• ?????P-R????lt0.12s
• QRS????gt0.12s
• QRS?????????
• P-J?????????ST-T??.

41
?????B?(????)

• V1??delta?????R???,??????V1??QRS????????,????????
  ?

42
LGL???(Lown-Ganong-Levine syndrome)

• ?P-R???
• ????????????????????James??????????,????????????
  ??????????????.
• ???P-R??lt0.12s
• QRS???????

43
Mahaim??????

• Mahaim????????????,?????????,????,??????
• P-R??????????,QRS????????
• ?????????????

44
???????

• ????????????????,?????????,?1-2?????
• ????(escape rhythm)??3??????
• ??????HR50-60?/?,?P???,P-R??,????????????????
• ???????HR40-60?/?
• ??????HR20-40?/?
• ????(reciprocal rhythm)??????QRS?????P?,???????,?
  ???,??QRS?

45
??????hyperkalemia

• ?Kgt5.5,Q-T????,T???
• ?Kgt6.5,QRS????,P-R?Q-T??,S-T??
• ?Kgt7,QRS????,P-R?Q-T??,P??????????K??????????

46
??????hypokalemia

• S-T???,T???????U???,T-U??,Q-T?????????,Q-T-U????,?
  ?K???,QRS????,P?????,
• ?K?????????????

47
???????????

• ?????(digitalis effect)S-T??????T?????????,??T??
  ?????,????????,ST-T????Q-T????
• ?????(digitalis toxicity)??????

48
????????

• ?????????? Q-T??,T???,??,u???,P???,P-R?????
• ???????? Q-T????,QRS??????(QRS??lt??25,???50??
  ???),?????????????

49
??????? 1.?????? 2.????????????? 3.?????????? 4.??
????????? 5.???
50
?????(AECG)ambulatory electrocardiography

• ????24???????
• ??????
• ???????????????
• ????????????
• ???????,????????
• ????????????????
• ???????????,??????
• ????????????

51
?????????ECG exercise test

• ???????????????
• ???????? ????????
• ??????220-??
• ???????????85-90

52
?????????

• ??????(bicycle ergometer test)
• ??????(treadmill test)

53
???????

• ???????????????????
• ??????????????
• ???????????????
• ??????????????????

54
???????

• ????????????
• ???????,????
• ??????????????
• ?????,?????????
• ???,????????
• ?????????

55
?????????????

• ?????????????????
• ?????????????
• ????????????
• ????????EKG????ST??02mv

56
????????

• ??????????
• ???EKG?ST??????????01mv,??1min??
• ???ST???01mv