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Arrhythmias

  • Clinical Updates in Women's Health Care CU
  • May 2017

ABSTRACT: Obstetrician–gynecologists often are the sole providers of health care to female patients. Because cardiovascular disease is the leading cause of death in women in the United States, obstetrician–gynecologists must be aware of the risk factors, symptoms, and signs of cardiovascular disease and arrhythmia. Furthermore, they must be prepared to identify and treat common types of arrhythmia in this population and refer patients to cardiology for specialized care. Understanding the role of pregnancy among women with arrhythmia is critically important to optimize both maternal and fetal outcomes. This monograph discusses the cardiac conduction system and addresses the assessment, diagnosis, and treatment of both pregnant and nonpregnant patients with heart rhythm disorders.

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Figures & Tables

Figure 1. Atrial fibrillation. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

Figure 1. Atrial fibrillation. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

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Figure 2. Supraventricular tachycardia, specifically antrioventricular tachycardia. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

Figure 2. Supraventricular tachycardia, specifically antrioventricular tachycardia. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

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Figure 3. Wolff–Parkinson–White syndrome. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

Figure 3. Wolff–Parkinson–White syndrome. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

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Figure 4. Multifocal atrial tachycardia. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

Figure 4. Multifocal atrial tachycardia. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

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Figure 5. First-degree heart block. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

Figure 5. First-degree heart block. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

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Figure 6. Second-degree heart block. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

Figure 6. Second-degree heart block. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

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Figure 7. Third-degree heart block. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

Figure 7. Third-degree heart block. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

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Figure 8. Nonsustained ventricular tachycardia. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

Figure 8. Nonsustained ventricular tachycardia. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

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Figure 9. Sustained monomorphic ventricular tachycardia. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

Figure 9. Sustained monomorphic ventricular tachycardia. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

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Figure 10. Polymorphic ventricular tachycardia. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

Figure 10. Polymorphic ventricular tachycardia. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

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Figure 11. Long QT interval. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

Figure 11. Long QT interval. (Nathanson L A, McClennen S, Safran C, Goldberger AL. ECG Wave-Maven: self-assessment program for students and clinicians. Boston (MA): Beth Israel Deaconess Medical Center; 2016. Available at: https://ecg.bidmc.harvard.edu/maven/mavenmain.asp . Retrieved April 3, 2017.)

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Figure 12. Schematic of the cardiac conduction system. (Goldberger AL. Electrocardiography. In: Kasper DL, Hauser SL, Jameson JL, Fauci AS, Longo DL and Loscalzo J, editors. Harrison’s principles of internal medicine. 19th ed. New York (NY): McGraw-Hill Education; 2015. p. 1451. ©McGraw-Hill Education. McGraw-Hill Education makes no representations or warranties as to the accuracy of any information contained in the McGraw-Hill Education Material, including any warranties of merchantability or fitness for a particular purpose. In no event shall McGraw-Hill Education have any liability to any party for special, incidental, tort, or consequential damages arising out of or in connection with the McGraw-Hill Education Material, even if McGraw-Hill Education has been advised of the possibility of such damages.)

Figure 12. Schematic of the cardiac conduction system. (Goldberger AL. Electrocardiography. In: Kasper DL, Hauser SL, Jameson JL, Fauci AS, Longo DL and Loscalzo J, editors. Harrison’s principles of internal medicine. 19th ed. New York (NY): McGraw-Hill Education; 2015. p. 1451. ©McGraw-Hill Education. McGraw-Hill Education makes no representations or warranties as to the accuracy of any information contained in the McGraw-Hill Education Material, including any warranties of merchantability or fitness for a particular purpose. In no event shall McGraw-Hill Education have any liability to any party for special, incidental, tort, or consequential damages arising out of or in connection with the McGraw-Hill Education Material, even if McGraw-Hill Education has been advised of the possibility of such damages.)

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