Computer assisted instruction in the diagnosis of cardiac arrhythmias

Disorders of heart rhythm, known as cardiac arrhythmias, are most accurately diagnosed from selected electrocardiographic (EKG) tracings. Their interpretation is necessary for the correct treatment, sometimes on an emergency basis, of a large number of patients with heart disease. Analysis of the contour and sequencing of component waveforms taken with the knowledge of the set of denned electrophysiologic mechanisms allows categorization and in most instances specific identification of the rhythm. Most of these diagnoses depend upon the specification of the site or sites of electrical impulse generation in the heart and its subsequent spread through specialized conduction pathways. The logical process leading to the diagnosis is inferential because the tissues involved in impulse generation and specialized conduction are of such small mass as to have no direct electrical representation on standard EKG leads. Only the electrical activation of larger masses of cardiac tissue as a resultant of those fundamental mechanistic events produces the component waveforms of the clinical electrocardiogram.