[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-573265-105":53,"doc-detail-573265-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","cardiac-arrhythmias-reference-notes-ecg-diagnosis-clinical-concerns","Cardiac Arrhythmias - Reference Notes - ECG Diagnosis & Clinical Concerns","","Reference notes on cardiac arrhythmias explain how heart rhythm disturbances can be classified by ventricular heart rate, anatomic origin (sinoatrial node, atria, atrioventricular, or ventricular), and electrophysiologic mechanism. The material outlines an ECG-based diagnostic workflow, covering lead and artifact identification, ventricular rate assessment, rhythm regularity patterns, P–QRS relationships, waveform morphology, conduction intervals (PR, QRS, QT), axis and QRS interpretation, and ST–T repolarization changes. It also summarizes main hemodynamic and clinical consequences, from bradyarrhythmias and supraventricular tachyarrhythmias to atrial fibrillation and ventricular ectopy.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":51,"@type":70,"position":76},"https://docshare.wps.com/template/general/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/cardiac-arrhythmias-reference-notes-ecg-diagnosis-clinical-concerns/573265/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/cardiac-arrhythmias-reference-notes-ecg-diagnosis-clinical-concerns/573265.png","ImageObject",442,249,{"name":88,"@type":89},"Pentious","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-16","2026-10-13",true,{"@type":98,"interactionType":99,"userInteractionCount":47},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"How can cardiac arrhythmias be classified in these reference notes?","Question",{"text":108,"@type":109},"They can be classified by ventricular heart rate (normal, bradyarrhythmia, tachyarrhythmia), anatomic origin (SA node, atria, AV, or ventricular), or electrophysiologic mechanism when evident.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What are the key steps for rhythm diagnosis using ECG in this material?",{"text":113,"@type":109},"The notes recommend analyzing lead/paper settings and artifacts, judging ventricular rate for the species, determining regularity and searching for patterns, identifying P and QRS complexes and their relationship (P–R and R–P), and reviewing morphology of P, QRS, and T waves plus conduction intervals.",{"name":115,"@type":106,"acceptedAnswer":116},"What clinical problems do arrhythmias cause according to the notes?",{"text":117,"@type":109},"The main concerns are hemodynamic effects such as reduced blood pressure and tissue perfusion, plus further electrical instability that can lead to myocardial fibrillation, with examples including reduced output in third-degree AV block and impaired filling in supraventricular tachyarrhythmias and atrial fibrillation.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},573265,1792097052,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":50,"category_name":51,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":47,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":8,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":79},1374404730887,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Cardiac Arrhythmias  \nReference Notes  \nJohn D. Bonagura, DVM, DACVIM (Cardiology, SAIM)  \nAdjunct Professor of Cardiology, NC State University, College of Veterinary Medicine  \nProfessor Emeritus, Veterinary Clinical Sciences, The Ohio State University  \nHeart rhythm disturbances (arrhythmias, dysrhythmias) can be classified based on the ventricular heart rate (normal, bradyarrhythmia, tachyarrhythmia); anatomic origin of the rhythm disturbance (sinoatrial node, atria, atrioventricular, or ventricular); or electrophysiologic mechanism, if evident. An overview of electrophysiologic mechanisms of arrhythmias is presented in class. These include abnormalities of impulse formation (enhanced automaticity, triggered activity) and various abnormalities of impulse conduction (including major conduction blocks such as atrioventricular (AV) block and right and left bundle branch blocks; “macro-retry” as with atrial flutter; disordered re-entry as with myocardial fibrillation; and other forms of re-entry around a focal zone of myocardial disease. ) Detailed models ofarrhythmogenesis are beyond the scope of this presentation.  \nDiagnosis  \nKeys to recognizing and diagnosing cardiac arrhythmias include an analysis of the atrial and the ventricular rates, regularity of the rhythm, identification of any patterns in irregular rhythms, P to QRS relationship, atrial waveform morphology (e.g. different than sinus node; flutter or fibrillation waves); morphology of the QRS complex (supraventricular or ventricular origin); and conduction intervals (especially duration of PR interval and duration of QRS complex) . In terms of a methodological approach to rhythm diagnosis, it is recommended that one consider analysis of the ECG (EKG) as follows:  \n1) Identify the patient, lead(s), paper speed, calibration signals, and artifacts;  \n2) Decide if the ventricular rate is slow, normal, or fast for the species;  \n3) Identify regularity or lack thereof and search for repetitive patterns in irregular rhythms;  \n4) Identify P and QRS complexes and the relationship between these waveforms (P-R intervals and the distance between the QRS and following P-waves (R-P)  \n5) Scrutinize morphology and consistency of the P-waves, QRS complexes, and T-waves;  \n6) Consider the conduction intervals across the atria (P-wave duration), atrioventricular conduction system (P-R interval), ventricles (QRS duration), and repolarization (Q-T)  \n7) Estimate the frontal axis and analyze the amplitude and terminal orientation of the QRS;  \n8) Evaluate the QRS morphology for conduction disturbances, obvious bundle branch or fascicular block patterns, and for changes typical of cardiomegaly;  \n9) Assess the ST segment and T-wave (ST-T) for repolarization abnormalities; and  \n10) Interpret the ECG with consideration of the entire clinical and laboratory picture.  \nThese are merely guidelines, but can assist with a methodical ECG analysis.  \nVermont VMA © John Bonagura, DVM, DACVIM – Cardiac Arrhythmias – Page 1  \nThe main clinical concerns about cardiac arrhythmias are hemodynamic effects such as reduced blood pressure (BP) and tissue perfusion and the promotion of further electrical instability leading to myocardial fibrillation. Bradyarrhythmias, as third-degree atrioventricular (AV) block, can reduce cardiac output by decreasing heart rate. Supraventricular tachyarrhythmias encroach on the diastolic filling periods, reducing preload and stroke volume. In the case of atrial fibrillation (AF), atrial contribution to ventricular filling is also lost, further impairing filling. Many ventricular arrhythmias are well-tolerated, but in other patients cause hypotension from reduced diastolic filling time, loss of normal atrioventricular coordination, and decreased mechanical synchrony between the two ventricles (due to abnormal current spread) . Additionally, relentless tachycardia can lead to a tachycardia-induced cardiomyopathy, a type of dilated cardiomyopathy that is reversible with c","cbCaivmg20NDDUEk","https://ap.wps.com/l/cbCaivmg20NDDUEk","pdf",828535,"English","# Diagnosis\n## ECG (EKG) analysis workflow\n# Clinical concerns\n## Hemodynamic effects and progression\n# Sinus rhythms\n## Normal sinus rhythm and sinus arrhythmia","[{\"question\":\"How can cardiac arrhythmias be classified in these reference notes?\",\"answer\":\"They can be classified by ventricular heart rate (normal, bradyarrhythmia, tachyarrhythmia), anatomic origin (SA node, atria, AV, or ventricular), or electrophysiologic mechanism when evident.\"},{\"question\":\"What are the key steps for rhythm diagnosis using ECG in this material?\",\"answer\":\"The notes recommend analyzing lead/paper settings and artifacts, judging ventricular rate for the species, determining regularity and searching for patterns, identifying P and QRS complexes and their relationship (P–R and R–P), and reviewing morphology of P, QRS, and T waves plus conduction intervals.\"},{\"question\":\"What clinical problems do arrhythmias cause according to the notes?\",\"answer\":\"The main concerns are hemodynamic effects such as reduced blood pressure and tissue perfusion, plus further electrical instability that can lead to myocardial fibrillation, with examples including reduced output in third-degree AV block and impaired filling in supraventricular tachyarrhythmias and atrial fibrillation.\"}]","Cardiac Arrhythmias - Reference Notes - ECG Diagnosis & Clinical Concerns | PDF",1791935854]