Understanding the ECG. Part 10: Pacing, drugs and electrolytes

This document is the Accepted Manuscript version of a Published Work that appeared in final form in British Journal of Cardiac Nursing, copyright © MA Healthcare, after peer review and technical editing by the publisher. To access the final edited and published work see 10.12968/bjca.2016.11.8.376 Over the past nine months, this series has examined the most important topics in ECG interpretation. These include cardiac anatomy and physiology, arrhythmias, heart blocks, preexcitation, the cardiac axis, chamber enlargement, and myocardial ischaemia (Garcia, 2015). We have also discussed many of the key principles of electrocardiography, and emphasised the need for a structured approach to ECG evaluation (Gregory, 2006). Inevitably in such a large subject, there are topics that we have not touched on. Some of these are less relevant to cardiac nurses, and some more so. In this last instalment of the series, we address three issues that have particular relevance to practitioners caring for cardiac patients. These are  The recognition of cardiac pacing and pacing problems  The ECG in the management of cardiovascular drugs  And the diagnosis of electrolyte disturbances. As with previous articles in the series, we will place the ECG in the context of clinical practice, and consider important aspects of patient management.