This patient was seen by his primary care provider (PCP) on an outpatient basis. The PCP decided to send her patient over to me to perform a routine ECG and establish a baseline, hince the computer's statement below of "No previous ECGs available". I printed out the above 12-lead ECG and became slightly concerned with the rhythm I was seeing. Consequently, I also recorded six full pages of continuous rhythm (not shown here). I don’t ordinarily resort to doing this
Our expert today is Dr. Ken Grauer. He is a frequent contributer to the ECG Guru.
KEN GRAUER, MDis ProfessorEmeritus (Dept. Community Health/Family Medicine, College of Medicine, University of Florida in Gainesville). Dr. Grauer has been a leading family physician educator for over 30 years. During that time he has published (as principal author) more than 10 books and numerous study aids on the topics of ECG interpretation, cardiac arrhythmias, and ACLS (including an ongoing Educational ECG Blog).
Answer: To see illustrated explanations of laddergrams, and how to use them, please use this link to his ECG Blog http://tinyurl.com/KG-Blog-69
Once your students have mastered the basic rhythms and their criteria, many of them will want to try more challenging rhythms. Non-conducted premature beats, retrograde conduction, AV blocks, and concealed conduction can be easily explained using LADDERGRAMS. A laddergram is a diagram of a rhythm strip showing the timing and conduction of the electrical impulses. There is a line drawn for the atrial activity, one for ventricular activity, and one for AV activity. Blocks and retrograde conduction
