a few things, using heart rate alone is not a good way to make an ecg dx, think about a "nornal" stress test, a 20y old would be expected to hit 200bpm (sinus) as their 100% of age predicted HR (220 - age) so the actual rate is too variable to depend upon for a dx, i am not saying to not consider the rate, just dont depend on it, also medical terminology needs to be very specific, when someone describes canon A waves this means something very specific, (usually atrial depol/contraction found the tricuspid valve closed/closing from ventricular contraction and cannon a wave is the result, usually implying a/v dissociation, pulmonary htn, tricuspid stenosis, etc, I am impressed someone took the time to document cannon a waves so this needs to be looked into as too why this pt has them, also terminology changes, when I was a medic 60bpm and less was brady, no 50bpm or less is brady, "normal" temp for a pt was 98.6, now over time and with much more data collected it seems 98.4 is closer to "normal" 
fun stuff
Paul  (PMMD)

Paul Matera, MD, EMTP



-----Original Message-----
From: Wouldn't Ü like to know <treborcline@...>
To: ekg_club@yahoogroups.com
Sent: Tue, Jul 14, 2009 6:25 am
Subject: [ekg_club] Re: SVT or junc tachycardia