Cardiac Arrhythmia: The Electric System of the Heart

by Carlo Raj, MD

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    00:00 it all begins with knowing the foundation. This is your conduction system of the heart no need for me to go into this in greater detail apart from the fact that there is the SA node. Pay attention to that, right atrium. What wave? P. I want you to go next to the AV node. The time that it takes to go from SA to AV, what interval is this? PR interval. What time have you memorized? 0.12 to 0.2 seconds. Good. From this, I want you to take a look at the bundle branches. You tell me. All I am doing is pointing out things that we have discussed already and now you can actually visualize it. Tell me about the left bundle and right bundle branch, which depolarizes first physiologically? Left bundle branch. How can you confirm that? Second heart sound. What is it? A2, P2. What does that mean? Aortic followed by pulmonic. Are you putting things together? Good. I want you to give you a patient a disease such as left bundle-branch block. If it is a left bundle-branch block, then you tell me what kind of split of S2? Good. Paradoxical split.

    01:06 What if it was the right bundle-branch block? Is it a fixed split or widened split? Widened split. If you don't know the difference, that is okay. That's a lot of information. Go back and review the difference between a fixed split most common diagnosis there, atrial septal defect. This is widened split with the right bundle-branch block. If you are good with those conduction systems, we are good. The only thing that I wish to point out to you? EC versus the AV node there. That AV node and on that wall. If you are passing an impulse anywhere apart from that AV node, then this would be known as what? An acessory pathway. Welcome to WPW. Okay. And we will walking through these later as well. So every single slide, every single piece of information that you are going to work with me here, you give it a clinical tag.

    01:57 If you don't, maybe perhaps you let it go for another time.

    About the Lecture

    The lecture Cardiac Arrhythmia: The Electric System of the Heart by Carlo Raj, MD is from the course Arrhythmias.

    Included Quiz Questions

    1. Left bundle branch block
    2. Right bundle branch block
    3. Ventricular septal defect
    4. Normal physiology on inspiration
    5. Atrial septal defect
    1. None are correct
    2. Left bundle branch block – widened split
    3. All are correct
    4. Atrial septal defect – paradoxical split
    5. Right bundle branch block – fixed split

    Author of lecture Cardiac Arrhythmia: The Electric System of the Heart

     Carlo Raj, MD

    Carlo Raj, MD

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