Atrial: 60 - 80 bpm

Junctional:  40-60 bpm

Ventricular:  20-40 bpm

1)  Rate

2)  Rhythm

3)  Axis

4)  Hypertrophy

5)  Infarction

• Primary prevention (EF≤35% and MI, NICM, or other DCM), including:
  - After recent MI (Coverage during the 40 day ICD waiting period)
  - Before and after CABG or PTCA (Coverage during the 90 day ICD waiting period)
  - Listed for cardiac transplant
  - Recently diagnosed nonischemic cardiomyopathy (Coverage during the 3 to 9 month ICD waiting period)
  - NYHA class IV heart failure
  - Terminal disease with life expectancy of less than 1 year
  
• ICD indications when patient condition delays or prohibits ICD implantation
• ICD explantation

1)  Irregular rhythms

2)  Escape

3)  Premature beats

4)  Tachy-arrhythmias

1) Wandering Pacemaker

2) Multifocal Atrial Tachycardia

3) Atrial Fibrillation

-  P' wave shape varies

-  atrial rate less than 100

-  irregular ventricular rhythm

characteristic of COPD

irregular rhythm

-  P' wave shape varies

-  atrial rate exceeds 100

-  irregular ventricular rhythm

irregular rhythm

-  continuous chaotic atrial spikes

-  irregular ventricular rhythm

Escape Rhythm - an automaticity focus escapes overdrive suppression to pace at its inherent rate:

-  Atrial Escape Rhythm

-  Junctional Escape Rhythm

-  Ventricular Escape Rhythm

Escape Beat - an automaticity focus transiently escapes overdrive suppression to emit one beat:

-  Atrial Escape Beat

-  Junction Escape Beat

-  Ventricular Escape Beat