Fig 19 - uploaded by Jaakko Malmivuo
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As discussed in Chapter 7, no unique solution exists for the inverse problem. From clinical practice it is possible to make accurate ECG diagnoses in some diseases and to estimate other diseases with an acceptable probability. How can this discrepancy between theory and practice be explained?
It was said in Chapter 7 that the inverse solution is im...
Citations
... SI, HS and GK were the attending consultants for the patients Fig. 2. Complete atrioventricular block and its ECG waveforms Complete atrioventricular block and its ECG waveforms [5]. ...
Introduction and importance
Bradycardia in pregnancy due to total atrioventricular block (TAVB) is a rare occurrence, often asymptomatic and may arise from a congenital disorder. Pacemaker is often required. Cases are few and management is not yet standardised.
Case presentation
A 24-year-old G2P0A1 of 9 months gestation presented with labor pains. She had had history of bradycardia diagnosed since a year prior but had not undergone tests nor received treatments. Her heart rate was 55-60 x/minute, her cardiotocography was reassuring and electrocardiogram revealed a TAVB with ventricular escape rhythm. As she had not had a pacemaker, an urgent cardiologist consultation was arranged during which a temporary pacemaker was installed. She underwent a caesarean section with general anaesthesia after which she had an uneventful recovery.
A 38-year-old G2P1A0 of 2 months of gestation presented with slow heart rhythm and a history of asthma to the outpatient clinic. She also had not undergone tests nor received medication. At presentation, her heart rate was 48 x/minute and her ECG revealed a TAVB with junctional escape rhythm. She had a pacemaker installed at 8 months of gestation and subsequently underwent an elective caesarean section at 37 weeks under regional anaesthesia. She had an uneventful recovery afterwards.
Clinical discussion
TAVB in pregnancy requires a concerted effort involving obstetricians, cardiologists, and intensivists. Pacemaker implantation is recommended. Whilst vaginal delivery remains first-choice, caesarean section is indicated under obstetric indications.
Conclusion
Screening, early recognition, risk stratification and thorough planning are required to successfully manage TAVB in pregnancy.
... The ECG test is a very popular and economic test used by the doctors to diagnose various heart diseases by analyzing various parameters of this signal [3]. The common problems are that a wave can be missing or an extra pulse may exist. ...
