2013 Arrhythmia Pacemaker 
Ken Grauer, MD
OCTOBER 13, 2023
Is a pacemaker needed? With P waves labeled — Isn't it now much easier to appreciate that the atrial rhythm is quite regular ( with no more than a slight sinus arrhythmia )? P utting I t A ll T ogether : The precise mechanism of today's arrhythmia is complex and difficult to determine. Is this " high -grade" AV block?
Dr. Smith's ECG Blog
AUGUST 14, 2024
This patient does not have a pacemaker, so this must be a ventricular escape rhythm. Redundant and diverse intranodal pacemakers and conduction pathways protect the human sinoatrial node from failure. The KEY to interpreting many complex arrhythmias lies with determination of what is and what is not a P wave. & Fedorov, V.
Ken Grauer, MD
OCTOBER 27, 2023
My Immediate Impression — was that this elderly woman with a several week history of symptoms would most likely leave the hospital with a pacemaker. Given this patient's older age — if nothing "fixable" is found, she most likely has SSS ( S ick S inus S yndrome ) and will need a pacemaker ( See ECG Blog #342 for more on SSS ).
Ken Grauer, MD
SEPTEMBER 29, 2023
KEY Point: When most beats in an arrhythmia are regular, but some are not — the best CLUE to interpretation often resides in looking for a “ break ” in the rhythm ( such as is seen between beats #13 and 14 in Figure-2 ). The simple step of labeling all of the obvious P waves — is surprisingly helpful in evaluating the rhythm.
Cardiometabolic Health Congress
AUGUST 30, 2024
Arrhythmias : A leadless pacemaker-defibrillator system provides antitachycardia pacing for ventricular tachycardia in patients with subcutaneous ICDs. Preventive Cardiology : The new PREVENT risk calculator is more accurate than the 2013 PCEs’ ASCVD risk estimates and is recommended for risk stratification.
Ken Grauer, MD
JANUARY 20, 2024
The patient may need a pacemaker. CASE F ollow- U p: Providers in today's case recognized the above abnormalities — and promptly referred the patient to a PCI center for cardiac catheterization and potential pacemaker insertion. == L ooking C loser at Today's R hythm: The rhythm in Figure-1 has a number of complexities.
Ken Grauer, MD
JANUARY 18, 2025
MY Thoughts on Figure-1: As always I favor the P s , Q s , 3 R Approach as an optimally time-efficient way to assess any arrhythmia, including the AV blocks ( See ECG Blog #185 ). Although there is slight variation in the P-P interval this type of ventriculophasic sinus arrhythmia is common with 2nd- and 3rd-degree AV blocks.
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