Old teaching tools should not be forgotten: The value of the Lewis ladder diagram in understanding bigeminal rhythms

Abstract

As medical education evolves, some traditional teaching methods often get forgotten. For generations, the Lewis ladder diagram (LLD) has helped students understand the mechanisms of cardiac arrhythmias and conduction disorders. Similarly, clinicians have used LLDs to communicate their proposed mechanisms to their colleagues and trainees. In this article, we revisit this technique of constructing the LLD and demonstrate this process by describing the mechanisms of various bigeminal rhythms.