6150 Craig VT Pt. 2

LV summit is probably the most ________ location of VT foci

common

LV summit signature ECG:

1. ______ axis (tall ___ wave)

2. lead I should be mostly _______

3. V1 should have ____/____ QRS; V1 QRS may start ______ than others

inferior; R; negative; short/small; later

papillary muscle:

1. PVCs usually in the _____ ventricular PMs

2. can come from ______ _______ PM

3. the ______-_______ PM is more common for foci than the _______-_______

left; anywhere along; posterior-inferior; antero-superior

PM PVC signature PVC:

1. sharp ___ waves in ____/____

2. V1 will have a ____ appearance bc PVC is coming from the LV (so _______ in V1)

3. for ALPM, lead II and aVF will have mostly ______ QRS whereas PMPM will have _______ QRS in inferior leads

q; aVR/V1; RBBB; positive; positive; negative

LV fascicular VT:

1. _____ predominance

2. _____-bundle branch pattern (______ in V1) and a _____ or ______ axis (inferior leads have _______ QRS)

3. most commonly involves the _____ ______ fascicle

4. usually relatively ______ QRS (because it is using the ________ system)

5. also called ________ VT

6. _______ mechanism

7. ________-sensitive (____ channel blocker, so it impacts conduction system)

male; right; positive; left or superior; negative; left posterior; narrow; conduction; Belhassen; reentry; verapamil; Ca++

because it is narrow, you need to look for ___ waves to see if there is ________ between A and V; no _______ is indicative of VT; may see _______ beats where the SAN conduction and V conduction ______ and the morphology is _________ than the beats around it

P; dissociation; association; fusion; meet; different

is the mechanism VT?

1. AV __________

2. QRS ______ and ______

3. QRS _________ and ________

4. “______” or ______ beats

5. do prior ECGs show _____ or _____

dissociation; width and axis; morphology and pattern; capture; fusion; BBB or WPW

LV fascicular reentry mechanism:

1. LPF is usually used in the ________ direction

2. cell to cell _______ through ____ until it gets to the end of the _____ and then goes backwards ______ up the _____

retrograde; slowly; LV; LPF; quickly; LPF

slow signals are also called _________ __________

diastolic potentials

tend to ablate part of the ____ at the earliest ______ ______; we interrupt the circuit where it _____ _______

LPF; purkinje potential; turns around

in NSR, we would see the purkinje potentials get gradually ________ as we go from MV towards apex, but in LV fascicular VT, the purkinje potential starts at the _____ and goes towards the ____

later; apex; MV

a notch in V1 is very characteristic of a focus in the ____/____ ______

RCC/LCC junction

Craig says the majority of PVC foci come from the ______ side of the ______, adjacent to the ___/___ of the _____, or in the ___ _______

septal; RVOT; RCC/LCC; LVOT; LV summit

placement of ECG leads is important:

1. V1/V2 are commonly placed too _____ on the chest (in the ___/___ intercostal space)

2. limb leads are commonly on the _____ of the ______ instead of the _____

high; 2nd/3rd; front; chest; limbs