2. Chapter 1 Electrophysiology
Gail Walraven, Basic Arrhythmias, Seventh Edition ©2011 by Pearson Education, Inc., Upper Saddle River, NJ

3. EKGs are graphic representations of electrical activity within the heart.
Gail Walraven, Basic Arrhythmias, Seventh Edition ©2011 by Pearson Education, Inc., Upper Saddle River, NJ

4. EKG
EKGs reflect electrical activity, not mechanical activity. To evaluate mechanical function, assess blood pressure and peripheral pulses.
Gail Walraven, Basic Arrhythmias, Seventh Edition ©2011 by Pearson Education, Inc., Upper Saddle River, NJ

5. EKG EKG can tell about electrical function: Rhythm disturbances
Conduction disturbances
Gail Walraven, Basic Arrhythmias, Seventh Edition ©2011 by Pearson Education, Inc., Upper Saddle River, NJ

6. EKG EKG cannot tell about mechanical function: Structural disorders
Perfusion disorders
Gail Walraven, Basic Arrhythmias, Seventh Edition ©2011 by Pearson Education, Inc., Upper Saddle River, NJ

7. The Sodium Pump Chemical Basis for Impulse Formation
Gail Walraven, Basic Arrhythmias, Seventh Edition ©2011 by Pearson Education, Inc., Upper Saddle River, NJ

8. Initiation of Electrical Flow
Polarization
“Ready” state
Depolarization
“Discharge” state
Repolarization
“Recovery” state
Gail Walraven, Basic Arrhythmias, Seventh Edition ©2011 by Pearson Education, Inc., Upper Saddle River, NJ

9. Electrical Conduction System
Gail Walraven, Basic Arrhythmias, Seventh Edition ©2011 by Pearson Education, Inc., Upper Saddle River, NJ

10. Inherent Rates Sinus Node 60-100 beats/min AV Junction 40-60 beats/min
Ventricles beats/min
Gail Walraven, Basic Arrhythmias, Seventh Edition ©2011 by Pearson Education, Inc., Upper Saddle River, NJ

11. Pacemaker Rule
Pacemaker site with the fastest rate will generally control the heart.
Gail Walraven, Basic Arrhythmias, Seventh Edition ©2011 by Pearson Education, Inc., Upper Saddle River, NJ

12. Irritability
A site along the conduction pathway becomes irritable and speeds up, thus overriding higher pacemaking sites for control of the heart.
Gail Walraven, Basic Arrhythmias, Seventh Edition ©2011 by Pearson Education, Inc., Upper Saddle River, NJ

13. Escape Mechanism
The normal pacemaker slows down or fails, and a lower pacing site assumes pacemaking responsibility.
Gail Walraven, Basic Arrhythmias, Seventh Edition ©2011 by Pearson Education, Inc., Upper Saddle River, NJ

14. Autonomic Nervous System
Gail Walraven, Basic Arrhythmias, Seventh Edition ©2011 by Pearson Education, Inc., Upper Saddle River, NJ