Automated Electrocardiographic Diagnoses

Part I. Heart Rhythm Diagnoses

Class 1. Cardiac pacemakers

• Sinus rhythm
• Right atrial rhythm
• Left atrial rhythm
• Atrial rhythm
• Low right atrial rhythm
• Low left atrial rhythm
• Low atrial rhythm
• Ectopic atrial rhythm
• Junctional rhythm
• Junctional rhythm with aberrant ventricular conduction
• Supraventricular rhythm
• Idioventricular rhythm

Class 2. Wandering pacemaker

• Wandering atrial pacemaker
• Consider wandering atrial pacemaker

Class 3. Heart rate

• Severe bradycardia
• Bradycardia (<60 bpm)
• Normocardia (60-100 bpm)
• Tachycardia (>100 bpm)
• Severe tachycardia
• Tachycardia
  • regular rhythm
  • irregular rhythm
    • HR
    • Ventricular rate

Class 4. AV Dissociation

• AV dissociation
  • escape complexes
  • transient
    • isorhythmia

Class 5. Fibrillation and flutter

• Atrial fibrillation
• Suggests atrial fibrillation
• Atrial flutter
• Atrial flutter with varying conduction
• Suggests atrial flutter
• Atrial fibrillation with third degree AV block
  • bradycardia
  • tachycardia
    • AV block or conduction ratio, 4:3
    • AV block or conduction ratio, 3:2
    • AV block or conduction ratio, 4:1
    • AV block or conduction ratio, 3:1
    • AV block or conduction ratio, 2:1

Class 6. Premature complexes

• Atrial premature complex(es)
• Junctional premature complex(es)
• Supraventricular premature complex(es)
• Left ventricular premature complex(es)
• Right ventricular premature complex(es)
• Ventricular premature complex(es)
• Suggests atrial premature complex(es)
• Suggests junctional premature complex(es)
• Suggests ventricular premature complex(es)
• Suggests left ventricular premature complex(es)
• Suggests right ventricular premature complex(es)
• Suggests ventricular premature complex(es)
  • early
  • late
  • interpolated
  • aberrantly conducted
  • nonconducted
    • occasional
    • frequent
    • couplets
      • monomorphic
      • polymorphic
        • bigeminy
        • trigeminy
        • quadrigeminy

Class 7. Paroxysmal tachycardia

• Paroxysmal tachycardia
• Paroxysmal tachycardia, consider atrial flutter
• Atrial fibrillation, consider atrial flutter
  • sinus
  • atrial
  • junctional
  • supraventricular
  • ventricular
    • intermittent

Class 8. Pre-excitation syndrome

• WPW pattern
• WPW pattern, type A
• WPW pattern, type B
• Consider WPW pattern
• Short PR interval
• Consider pre-excitation

Class 9. Sinoatrial block

• Sinoatrial block, type I
• Sinoatrial block, type II
• Sinus arrest or pause
  • conduction 4:3
  • conduction 3:2
  • conduction 4:1
  • conduction 3:1
  • conduction 2:1

Class 10. AV block

• First-degree AV block
• Second-degree AV block, Mobitz Type 1 (Wenckebach)
• Second-degree AV block, Mobitz Type 2
• AV block, advanced (high-grade)
• Second-degree AV block
• AV block, complete (third-degree)

Class 11. Parasystole

• Parasystole
• Suggests parasystole

Class 12. Unidentified arrhythmia

• Unidentified arrhythmia

Class 13. Noise, drift, Filter

• High noise level in leads
• Baseline drift
• Baseline drift in lead
• Baseline drift in leads
• Filter is on

PART II. QRS shape diagnoses

Class 1. General ECG conclusion

• Normal ECG
• Otherwise normal ECG
• Abnormal ECG
• Technical error, consider dextrocardia
• Suggests dextrocardia
• Misplaced specified electrodes: R & L

Class 2. QRS axis

• Normal axis
• Right axis deviation
• Right axis deviation, consider right ventricular hypertrophy and left posterior fascicular block
• Indeterminate axis
• Left axis deviation, consider left anterior fascicular block
• Left axis deviation

Class 3. Atrial syndrome

• Right atrial enlargement
• Suggests right atrial enlargement
• Left atrial enlargement
• Suggests left atrial enlargement
• Atrial conduction abnormality

Class 4. Intraventricular block

Right bundle branch block

• Complete right bundle branch block
• Suggests incomplete right bundle branch block
• rSr' pattern in V1 or V2

Left bundle branch block

• Complete left bundle branch block
• Incomplete left bundle branch block
• Suggests incomplete left bundle branch block and old anteroseptal myocardial infarction
• Left anterior fascicular block
• Suggests left anterior fascicular block
• Left posterior fascicular block

Bifascicular and trifascicular block

• Complete right bundle branch block and left anterior fascicular block
• Complete right bundle branch block and left posterior fascicular block
• Trifascicular block
• Consider trifascicular block
• Intraventricular block
• Intraventricular conduction delay

Class 5. Myocardial infarction

• Myocardial infarction
• Suggests myocardial infarction
  • anterobasal
  • anterolateral
  • inferior
  • anteroseptal
  • extensive anterior
  • anterior and inferior
  • inferolateral
  • inferoseptal
  • inferoаpical
  • extensive inferior
    • acute
    • of indeterminate age
    • old
• Abnormal Q wave, consider myocardial infarction, hypertrophic cardiomyopathy, coronary artery anomalies
• Consider inferobasal myocardial infarction

Class 6. Ventricular hypertrophy

Right ventricular hypertrophy

• Right ventricular hypertrophy, consider right ventricular strain
• Right ventricular hypertrophy
• Right ventricular hypertrophy, consider chronic obstructive pulmonary disease
• Suggests right ventricular hypertrophy with strain
• Suggests right ventricular hypertrophy
• Suggests right ventricular hypertrophy with systolic strain
• Suggests right ventricular hypertrophy with diastolic strain

Left ventricular hypertrophy

• Left ventricular hypertrophy, consider left ventricular strain
• Left ventricular hypertrophy
• Left ventricular hypertrophy with systolic strain
• Left ventricular hypertrophy with diastolic strain
• Suggests left ventricular hypertrophy
• Left ventricular hypertrophy by voltage criteria

Class 7. Other depolarization syndromes

• SI SII SIII pattern, consider right ventricular hypertrophy, pulmonary disease
• SI QIII TIII pattern, consider pulmonary embolism
• Low voltage
• High voltage
• Electrical alternans

Class 8. ST and T changes

• ST deviation
• T-wave change
• ST deviation and/or T-wave change
• T-wave change
• Nonspecific ST deviation
• Nonspecific T-wave change
• Nonspecific ST deviation with T-wave change
  • most evident
  • major
  • moderate
  • minor
  • possible
    • anterobasal
    • anterolateral
    • inferior
    • anteroseptal
    • anteroapical
    • extensive anterior
    • anterior and inferior
    • inferolateral
    • inferoseptal
    • inferoаpical
    • extensive inferior

Class 9. Other repolarization syndromes

• ST elevation, consider myocardial infarction, pericarditis, early repolarization
• ST elevation, consider pericarditis, early repolarization
• Suggests ST elevation, consider myocardial infarction, pericarditis, early repolarization
• Suggests ST elevation, consider pericarditis, early repolarization
• Suggests early repolarization
• Tall T-waves in V1-V4, consider inferobasal ST-T changes, hyperkalemia
• ST elevation in V1-V4, consider enhanced vagal tone, hyperkalemia, inferobasal ST-T changes
• Nonspecific T-wave changes T(V1) > T(V6)
• Consider digitalis effect
• Juvenile T waves
• Short QT interval
• Prolonged QT interval