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| Value of ECG waterfall chart in diagnosing sinus rhythm complicated by competitive arrhythmias |
| ZHANG Fangfang, JING Yongming, LI Shifeng, LI Zhongjian |
| Department of Electrocardiography, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou Henan 450014, China |
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Abstract Objective To explore the value of electrocardiogram(ECG) waterfall chart in the analysis of sinus rhythm complicating competitive arrhythmias. Methods We retrospectively analyzed the changes of ECG waterfall charts of ambulatory electrocardiography among 41 patients with sinus rhythm complicating competitive arrhythmias, and summarized their characteristics. Results During sinus rhythm, ECG waterfall chart is continuously and stably manifested by P, QRS, and T peak bands with the same color. In the occurrence of competitive arrhythmias, the P, QRS and T peak bands change in color, or the P peak band drifts. The characteristics of the waterfall chart of sinus rhythm complicating atrial autonomic rhythm are as follows: P peak band is split while R and T peak bands remain the same. The characteristics of the waterfall chart of sinus rhythm complicating junctional autonomic rhythm are as follows: PR interval changes, P peak band splits and drifts (even drifting to the bottom of the R peak band) while the R and T peak bands remain unchanged. The characteristics of the waterfall chart of sinus rhythm complicating ventricular autonomic rhythm are as follows: P, QRS, and T peak bands synchronously change colors. Conclusion When competitive arrhythmias and sinus rhythm are intertwined together, we can accurately grasp the onset time and duration of competitive arrhythmias by selecting the lead with obvious changes of PQRST complex, and observe the changes of P, QRS and T peak bands in the ECG waterfall chart.
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