Electrocardiography of Heart Failure: Features and Arrhythmias

  • J. L. Atlee
Part of the Topics in Anaesthesia and Critical Care book series (TIACC)


While this chapter addresses the electrocardiographic (ECG) features of heart failure (HF) and physiologically significant arrhythmias in patients with HF, neither ECG findings nor specific arrhythmias establish the diagnosis of HF, regardless of its origin. The diagnosis of HF is established by the patient’s symptoms and physical signs, along with confirmatory evidence of mechanical heart dysfunction (e.g., by echocardiography or cardiac catheterization). HF can be due to systolic and/or diastolic dysfunction affecting one or both ventricles. Regardless of which, because of ventricular interdependence, HF ultimately leads to compromise of both systemic and pulmonary hemodynamics. Unchecked, the end result is multiorgan system failure and death, whether HF results from congenital or acquired heart disease. This chapter highlights the ECG features of HF and arrhythmias in patients with HF.


Right Ventricle Cardiac Resynchronization Therapy Left Ventricular Free Wall Atrial Mass Atrial Rhythm 
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  1. 1.
    Givertz MM, Colucci WS, Braunwald E (2005) Clinical aspects of heart failure; pulmonary edema, high-output failure. In: Zipes DP, Libby P, Bonow RO, Braunwald E (eds) Braunwald’s heart disease, 7th edn. Elsevier Saunders, Philadelphia, pp 539–568Google Scholar
  2. 2.
    Hunt SA, Baker DW, Chin MH et al (2001) ACC/AHA Guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). Circulation 104:2996–3007PubMedGoogle Scholar
  3. 3.
    Chin MH, Goldman L (1997) Factors contributing to the hospitalization of patients with congestive heart failure. Am J Public Health 87:643–648PubMedCrossRefGoogle Scholar
  4. 4.
    Mirvus DM, Goldberger AL (2005) Electrocardiography. In: Zipes DP, Libby P, Bonow RO, Braunwald E (eds) Braunwald’s heart disease, 7th edn. Elsevier Saunders, Philadelphia, pp 107–185Google Scholar
  5. 5.
    Wagner GS (2001) Marriott’s practical electrocardiography, 10th edn. Lippincott, Williams & Wilkins, Philadelphia, pp 72–94Google Scholar
  6. 6.
    Atlee JL (1996) Arrhythmias and pacemakers. Saunders, Philadelphia, pp 105–153Google Scholar
  7. 7.
    Olgin JE, Zipes DP (2005) Specific arrhythmias: diagnosis and treatment. In: Zipes DP, Libby P, Bonow RO, Braunwald E (eds) Braunwald’s heart disease, 7th edn. Elsevier Saunders, Philadelphia, pp 803–863Google Scholar
  8. 8.
    Menotti A, Seccareccia F (1997) Electrocardiographic Minnesota code findings predicting short-term mortality in asymptomatic subjects. The Italian RIFLE Pooling Project (Risk Factors and Life Expectancy). G Ital Cardiol 27:40–49PubMedGoogle Scholar
  9. 9.
    Sundstrom J, Lind L, Arnlov J, et al (2001) Echocardiographic and electrocardiographic diagnoses of left ventricular hypertrophy predict mortality independently of each other in a population of elderly men. Circulation 103:2346–2351PubMedGoogle Scholar
  10. 10.
    Jain A, Chandna H, Silber EN, et al (1999) Electrocardiographic patterns of patients with echocardiographically determined biventricular hypertrophy. J Electrocardiol 32:269–273PubMedCrossRefGoogle Scholar
  11. 11.
    Atlee JL (2006) Pacemaker resynchronisation in the treatment of severe heart failure. In: Gullo A (ed) Anaesthesia, pain, intensive care and emergency medicine (A.P.I.C.E.) 20. Springer, Milan, pp 99–112Google Scholar
  12. 12.
    Opie LH (2005) Mechanisms of cardiac contraction and relaxation. In: Zipes DP, Libby P, Bonow RO, Braunwald E (eds) Braunwald’s heart disease, 7th edn. Elsevier Saunders, Philadelphia, pp 457–489Google Scholar
  13. 13.
    La Rovere MT, Pinna GD, Maestri R, et al (2003) Short-term heart rate variability strongly predicts sudden cardiac death in chronic heart failure patients. Circulation 107:565–570PubMedCrossRefGoogle Scholar
  14. 14.
    Singh SN, Fisher SG, Carson PE, Fletcher RD (1998) Prevalence and significance of nonsustained ventricular tachycardia in patients with premature ventricular contractions and heart failure treated with vasodilator therapy. Department of Veterans Affairs CHF STAT Investigators. J Am Coll Cardiol 32:942–947PubMedCrossRefGoogle Scholar
  15. 15.
    Moss AJ, Zareba W, Hall WJ, et al (2002) Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 346: 877–883PubMedCrossRefGoogle Scholar
  16. 16.
    Salukhe TV, Francis DP, Sutton R (2003) Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure (COMPANION) trial terminated early; combined biventricular pacemaker-defibrillators reduce all-cause mortality and hospitalization. Int J Cardiol 87:119–120PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • J. L. Atlee
    • 1
  1. 1.Department of AnesthesiologyMedical College of WisconsinMilwaukeeUSA

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