article thumbnail

Low prevalence of CRT upgrade in patients with significant RV pacing: 10-year real-world data in a UK DGH

The British Journal of Cardiology

In heart failure patients with reduced ejection fraction (HFrEF) requiring a pacemaker, biventricular cardiac resynchronisation therapy (CRT) is preferred to right ventricular (RV) pacing. We aim to report the prevalence and characteristics of CRT upgrades in a UK district general hospital over a 10-year period.

article thumbnail

Paced QRS morphology mimicking complete left bundle branch block induced by right ventricular pacing is associated with pacing?induced cardiomyopathy

Journal of Cardiovascular Electrophysiology

Complete left bundle branch block (CLBBB)-like QRS morphology of right ventricular pacing at pacemaker implantation satisfying the American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society criteria of CLBBB was associated with development of pacing induced cardiomyopathy.

article thumbnail

How terrible can it be to fail to recognize OMI? To whom is OMI Obvious or Not Obvious?

Dr. Smith's ECG Blog

A temporary pacemaker was implanted, and she was admitted to the ICU with cardiogenic shock. 2009;Available from: [link] 4. She was worked as a full code, and ROSC was achieved. She was taken to the cath lab, where she was found to have 100% in-stent restenosis of the proximal LAD. She could not be resuscitated. Heart [Internet].

article thumbnail

Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

Dr. Smith's ECG Blog

Again, see Ken's discussion below) Discussion continued The absence of pace spikes suggests this is not a pacemaker/ICD-related rhythm in this patient with an ICD. Are the apparent P-waves (which now we suspect might not be P-waves) actually part of the QRS, in which case the QRS is even wider than it appears? Where does the QRS begin?

article thumbnail

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Negative predictors of adverse outcome: Pacemaker Pre-syncope or "near-syncope," but there is still some small risk (5, 18) These last two are identified in studies, but I consider them dangerous signs and symptoms in their own right, as above: 10. —QRS Arch Intern Med 2009 Jul 27; 169:1262. Arch Intern Med 2009 Jul 27; 169:1305.

article thumbnail

Syncope and a short pause on event monitor

Dr. Smith's ECG Blog

If the block is not vagal in nature, the patient should receive a pacemaker. There was a randomized trial to determine whether pacemakers could benefit patients with vasovagal syncope, aptly named The North American Vasovagal Pacemaker Study (VPS). In the repeat study (VPS II), EVERY patient had an implanted pacemaker.