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Arrhythmia Recognition: The Art of Interpretation

Author(s): Tomas B. Garcia, MD
Geoffrey T. Miller, AS, EMT-P
  • ISBN-13: 9780763722463
  • ISBN-10:0763722464
  • Paperback    633 pages      © 2004
Price: $153.95 US List
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An American Journal of Nursing 2004 Book of the Year!

Arrhythmia Recognition: The Art of Interpretation uses hundreds of four-color graphics to communicate the complex topics related to arrhythmia recognition. The text focuses on the pathophysiological mechanisms involved in the formation and maintenance of complex arrhythmias and on their clinical recognition. Each rhythm strip provides a descriptive table outlining the various abnormalities in a logical, easy-to-follow sequence. In addition, there are analytical narratives outlining what providers should consider when approaching the strip. The tables and analytical narratives are intended to formulate functional interpretative skills to consider when approaching a complex arrhythmia in a clinical situation.

There are hundreds of individual rhythm strips contained within the text, each with a small descriptive table outlining the various abnormalities in a logical, easy-to-follow sequence. In addition, there are small descriptive narratives outlining the author’s thought processes when approaching the strip. This table and description process is intended to formulate functional interprepative skills for the student when approaching a complex arrhythmia in a clinical situation.

This text also contains over 100 test strips to sharpen students' skills in approaching unknown rhythms. Each of the test strips also contains the tables and narratives outlined above so that students can check their rationale against the author’s.

Arrhythmia Recognition: The Art of Interpretation is the third book in a series which covers the various levels of electrocardiographic education including 12-Lead ECGs and Arrhythmias.

Features & Benefits

Rhythm Strips - Over 575 real-life rhythm strips appear throughout the text, alongside clear explanations of the thought process used to recognize the rhythm.  The text concluded with a final self-test of 75 rhythm strips, complete with interpretations.

Graphics - More than 275 full-color illustrations aid comprehension of arrhythmia interpretation.

Web Resources - Additional resources are available online to enhance arrhythmia recognition, including:

  • Practice rhythm strips
  • Rhythm quizzes
  • Terminology flashcards
  • Online glossary
  • Web links

Applicable Courses


This course is a comprehensive introduction to the diagnosis and anatomy of the cardiac construction system. The course covers cardiac electrical activity, supraventricular and ventricular arrhythmias, disorders of conduction, and types of techniques used in evaluating arrhythmias, as well as electrocardiographic interpretation. It also discusses the pharmacology of anti arrhythmic drugs. This course is suitable for all radiological technologists, especially those working in a cardiac cath lab setting; radiology nurses, cardiac cath lab nurses, ER, ICU, CCU nurses; and cardiovascular technologists and students.

Section I: Introduction to Arrhythmia Recognition
Chapter 1: Anatomy
Chapter 2: Electrophysiology
Chapter 3: Vectors and the Basic Beat
Chapter 4: The Rhythm Strip, Tools, and Calculating Rates
Chapter 5: Basic Concepts in Arrhythmia Recognition
Chapter 6: Relevant Topics in Basic Electrocardiography
Chapter 7: Arrhythmias: A Quick Review

Section II: Sinus Rhythms
Chapter 8: Normal Sinus Rhythm
Chapter 9: Sinus Bradycardia
Chapter 10: Sinus Tachycardia 
Chapter 11: Sinus Arrhythmia
Chapter 12: Sinus Blocks, Pauses, and Arrests
Section II Self-Test

Section III: Atrial Rhythms
Chapter 13: Premature Atrial Contraction
Chapter 14: Ectopic Atrial Rhythm
Chapter 15: Ectopic Atrial Tachycardia
Chapter 16: Ectopic Atrial Tachycardia with Block
Chapter 17: Wandering Atrial Pacemaker
Chapter 18: Multifocal Atrial Tachycardia
Chapter 19: Atrial Flutter
Chapter 20: Atrial Fibrillation
Section III Self-Test

Section IV: Junctional Rhythms
Chapter 21: Introduction to Junctional Rhythms
Chapter 22: Junctional Rhythm
Chapter 23: Premature Junctional Contraction
Chapter 24: Rapid Junctional Rhythms
Chapter 25: AV Nodal Reentry Tachycardia
Chapter 26: AV Reentry Tachycardia
Chapter 27: How to Approach a Narrow-Complex Tachycardia 
Section IV Self-Test

Section V: Ventricular Rhythms
Chapter 28: Introduction to Ventricular Rhythms 
Chapter 29: Premature Ventricular Contraction 
Chapter 30: Ventricular Escape and Idioventricular Rhythms
Chapter 31: Ventricular Tachycardia
Chapter 32: Polymorphic Ventricular Tachycardia and Torsade de Pointes
Chapter 33: How to Approach a Wide-Complex Tachycardia
Chapter 34: Ventricular Fibrillation and Asystole
Section V Self-Test

Section VI: Additional Rhythms and Information
Chapter 35: Atrioventricular Block
Chapter 36: Artificially Paced Rhythms
Chapter 37: Putting It All Together

Section VII: Final Test
Chapter Review Answers
Recommended Reading

Tomas B. Garcia, MD

Tomas B. Garcia, MD

Dr. Tomas B. Garcia received his undergraduate degree from Florida International University. While applying to medical school, Dr. Garcia was licensed and practiced as an EMT in the state of Florida. Dr. Garcia received his medical degree from the University of Miami. He completed his internship and residency at Jackson Memorial Hospital in Miami, Florida and subsequently received board certification in both Internal Medicine and Emergency Medicine. Dr. Garcia taught and practiced in the Emergency Department of the Brigham and Women's Hospital/Harvard Medical School in Boston, Massachusetts and Grady Memorial Hospital/Emory Medical School in Atlanta, Georgia. His main area of interest is emergency cardiac care and he lectures nationally on topics related to these issues.

Geoffrey T. Miller, AS, EMT-P

Geoffrey T. Miller is the associate director of Research and Curriculum Development for the Division of Prehospital and Emergency Healthcare at the Michael S. Gordon Center for Research in Medical Education (GCRME) at the University of Miami Miller School of Medicine. Mr. Miller began his career in public safety 20 years ago. Previously Mr. Miller worked as a paramedic fire fighter with Alachua County Fire Rescue before moving into EMS education. During his time with Alachua County Fire Rescue, he also oversaw projects on system utilization and hospital diversions, and he assisted in the development and implementation of E911 system upgrades, electronic patient tracking, and reporting and medical care protocol refinements. Following his service in fire rescue, Mr. Miller served as associate professor of EMS programs at Santa Fe Community College in Gainesville, Florida. There he led the school’s participation as a field test site in the pilot testing of the US Department of Transportation national standard curriculum for paramedics.

Mr. Miller joined the GCRME more than 9 years ago and has since worked in the areas of patient simulation, interactive multimedia computer learning systems, emergency medical skills training, terrorism response, and disaster medical response and management. He is active in the areas of applied outcomes research in education, with an emphasis on the creation and improvement of methods of clinical competence assessment using advanced educational technology and simulation. Presently Mr. Miller develops, implements, disseminates, and evaluates innovative EMS curricula and assessment systems that are used by prehospital providers, medical schools, and US Army medical teams throughout the United States.

Mr. Miller is actively engaged in scholarly research and publication in EMS practice and education. He has coauthored several books, including Arrhythmia Recognition: The Art of Interpretation. Mr. Miller is a frequent author and coauthor in emergency medical services and emergency care journals. He is regularly invited to speak at state, national, and international conferences.

Mr. Miller is a member of numerous local, state, and national EMS professional organizations and committees that advise fire rescue, EMS, law enforcement, public health, and hospitals. Mr. Miller is also an active member of national and Florida state educational organizations and has served twice as the president of the Florida Association of EMS Educators. In 2000, Mr. Miller was recognized as the Paramedic Instructor of the Year by the Florida Association of EMS Educators. In 2003, he was recognized as the EMS Educator of the Year by the State of Florida Department of Health Bureau of EMS. In 2005, he received the Mary Ann Talley award for EMS education from the National Association of Emergency Medical Technicians.

  • "I found the Garcia's Arrhythmias' text to be an excellent adjunct to current Paramedic Course textbooks. The process I used was to give the initial lecture from the Paramedic book, follow with the Garcia text, and finish with the ACLS lecture that pertained to that rhythm. The students were able to grasp each rhythms identity more clearly, leading to higher student success."

    Ted Huffman
    Program Manager
    Fire Training Academy

    Book Review:  Arrhythmia Recognition: The Art of Interpretation, By Tomas B. Garcia, MD, & Geoffrey T. Miller, NREMT-P: Jones and Bartlett Publishers, 2004

    Appeared in the April, 2004 issue of JEMS Magazine.

    The ability to rapidly and correctly interpret dysrhythmias is the cornerstone on which emergency cardiac care is built.  This melding of knowledge about cardiac anatomy and electrophysiology with the practical ability to read and constantly reassess a patient’s ECG rhythm makes all other emergency cardiac care interventions possible.

    Any textbook that sets out to teach the recognition and interpretation of ECG rhythms must seamlessly integrate anatomy and electrophysiology and then immerse the student in the resultant ECGs.  Arrhythmia Recognition: The Art of Interpretation by Garcia and Miller is such a book. 

    Much like Dale Dubin’s landmark Rapid Interpretation of EKGs, Arrhythmia Recognition: The Art of Interpretation is logical and pragmatic in its approach to teaching dysrhythmias.  What most clearly sets this book miles apart from Dubin’s is its rich and vibrant illustrations, which make the pages feel about three-dimensional.  To compare the visual impact of this book to Dubin’s classic is akin to comparing a color laser printer to a dot matrix printer.

    This book is far more thorough in its approach to teaching the subject matter than most other books on the market.  It’s a highly “readable” textbook that keeps your attention.

    If I had to make improvements in the contents of this excellent text, it would be in two areas.  First, although the book includes 75 unknown ECG rhythm strips in its “Final Test” section for recognition practice, I’d like to see even more practice ECGs because more is always better for a learning student.  (Gail Walraven’s Basic Arrhythmias book, from which I learned about dysrhythmias in 1981, has 220 practice strips.)  Finally, it would also be great to see a subsequent edition of this text address the basics of 12-lead ECG’s, including injury and ischemia in the same colorful and dynamic format of the current text.  The lack of 12-lead ECG interpretation makes this excellent book fall short as a one-stop shopping for a supplemental ECG text to the standard paramedic course textbooks. 

      -Edward T. Dickinson, MD, NREMT-P, FACEP, JEMS Medical Editor 

    Editors' note: Lead author Tomas Garcia, along with Neil Holtz, EMT-P, has already tackled the topic of 12-leads in two books: Introduction to 12-Lead ECG: The Art of Interpretation and 12-Lead ECG: The Art of Interpretation, both from Jones and Bartlett. 

    "Arrhythmia Recognition uses graphics to simplify and explain some of the more challenging topics. I know this will be a great benefit to students who are having a hard time "seeing" what's happening. The text also introduces topics that have previously not been included in Basic EKG books, such as vectors and 12 leads. It appears that there is a good balance, and it should help and not overwhelm new students.

    I like the "real world" approach that Dr. Garcia utilizes in writing the text. It eliminates some of the sterile aspects of many medical texts. He stresses not to make interpretations in a vacuum, and to always treat the patient, not the monitor. This is profoundly important in getting newer clinicians off to the right start.  Plus, the self-tests at the end of each chapter are vital to reinforce newly learned material."

    William E. Aiken, MHA, NREMT-P
    Lieutenant, Henrico County (VA) Division of Fire

    “I have been instructing Paramedic students since 1992.  Every year I teach the Cardiology semester, and we have used several different texts to teach cardiac dysrhythmias.  This is our first semester using Arrhythmia Recognition: The Art of Interpretation by Dr. Garcia.  This is the best text I have ever used to teach this part of the Cardiology course.  It is well written, full of valuable information, and has excellent Instructor support materials. The illustrations and rhythm strips are extremely well presented.  One added bonus: my students love this book!  Bravo to Jones-Bartlett Publishing for providing this outstanding textbook!”

    Ronald Johnson, D.O.
    Program/Medical Director, EMS Programs
    Department of Nursin, Central Texas College



Instructor's ToolKit CD-ROM

ISBN-13: 9780763731359 ISBN-10: 0763731358

This CD-ROM contains PowerPoint presentations, lecture outlines, and an image bank including all of the images that appear in Arrhythmia Recognition:  The Art of Interpretation.

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