Ken Grauer, MD

FEBRUARY 9, 2024

Whatever the specific etiology of today's arrhythmia is, the “good news” is — that this rhythm will most probably improve with reperfusion of the "culprit" artery. That said — I found today's arrhythmia fascinating, and worthy of more in-depth analysis. Using calipers facilitates the process.

Blog 106

Blog Arrhythmia STEMI Bradycardia 106

Ken Grauer, MD

MAY 11, 2024

With 2nd- or 3rd-degree AV block — the atrial rate should be regular ( or at least almost regular — if there is an underlying sinus arrhythmia ) — but it should be clear from the timing of the RED arrows in Figure-2 — that no on-time P wave occurs between beats #1-2; #3-4; #5-6; #7-8; #9-10; #11-12.

Blog 109

Blog Arrhythmia Download 109

DAIC

FEBRUARY 12, 2024

2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/Amedrican Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Technol Health Care. 2023;31(2):735-746. doi: 10.3233/THC-220432.

Technology 64

Technology Atrial Fibrillation Defibrillator Sudden Cardiac Death 64

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.

Blog 99

Blog Download Arrhythmia Pacemaker 99

Ken Grauer, MD

APRIL 23, 2023

Realizing that slight variation in the P-P interval is common ( known as sinus arrhythmia ) — the PINK arrows in Figure-3 suggest the probable location of underlying sinus P waves. Certain complex arrhythmias may have more than a single plausible rhythm interpretation. This is precisely what we see in Figure-4.

Blog 78

Blog Chest Pain Arrhythmia Download 78

Ken Grauer, MD

JANUARY 20, 2024

PEARL # 7: As is evident for many of the examples of AV block that have appeared in this ECG Blog — it is common to see a " ventriculophasic " sinus arrhythmia in association with 2nd or 3rd degree AV block. Smith's ECG Blog. A DDENDUM ( 1/20/2024 ) : Included below is a series of additional material relevant to today's case.

Blog 95

Blog Bradycardia STEMI Download 95

Ken Grauer, MD

JANUARY 5, 2024

Section 2F ( 6 pages = the " short " Answer ) from my ECG-2014 Pocket Brain book provides quick written review of the AV Blocks. Assuming this patient is at least momentarily stable — I’d then proceed as follows: I’d take a quick look at the long lead rhythm strip.

Blog 178

Blog Chest Pain Arrhythmia 178

Dr. Smith's ECG Blog

SEPTEMBER 9, 2020

== MY Arrhythmia Case by K EN G RAUER, MD ( 9/9/2020 ): == PREFACE: Recognition of the presence ( or absence ) of AV block is a common problem in emergency medicine. I find it helpful in sorting out complex arrhythmias to search out P waves at an early point in the process. Is There a Regular P Wave Rhythm?

Arrhythmia 52

Arrhythmia Physiology Hospital Blog 52

Ken Grauer, MD

APRIL 13, 2024

P utting I t A ll T ogether: At this point in my assessment of today's rhythm — I fully acknowledge that I did not know for certain the etiology of this arrhythmia. PEARL # 2: The ECG may provide clues to the underlying severity of the ASD in a given patient — especially in the adult patient who is not overtly symptomatic.

Blog 118

Blog Tachycardia Pulmonary Arrhythmia 118

Ken Grauer, MD

OCTOBER 27, 2023

L addergram I llustration : At this point — I needed to work out, and then draw a laddergram that I could then verify to ensure a plausible mechanism for today's arrhythmia. Note also that the P-P interval between successive P waves ( vertical RED lines ) is similar, albeit not quite equal ( ie, There is slight sinus arrhythmia ).

Blog 103

Blog Pacemaker Bradycardia Arrhythmia 103

Dr. Smith's ECG Blog

JULY 22, 2023

Prior to Mizusawa's study, it was thought that the incidence of syncope, arrhythmia, or SCD in this cohort was low [7]. In light of the risk of arrhythmia events observed in the Mizusawa trial, a formal EP study might be reasonable to obtain in those with fever induced asymptomatic Brugada ECG changes to help risk stratify these patients.

Chest Pain 70

Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia 70

Dr. Smith's ECG Blog

OCTOBER 13, 2022

CMAJ 2014. Int J Cardiol 2014. == MY Comment by K EN G RAUER, MD ( 10/13/2022 ): == I suspect most cases of acute OMI that occur in association with WPW — are overlooked! Electrocardiography in the patient with the Wolff-Parkinson-White syndrome: diagnostic and initial therapeutic issues. Am J Emerg Med 1999. Chang and Liu.

Chest Pain 52

Chest Pain Myocardial Infarction Ischemia STEMI 52

Dr. Smith's ECG Blog

OCTOBER 24, 2018

Although there is no long lead rhythm strip — it is noteworthy that there is marked sinus arrhythmia in ECG #1. This finding is easy to overlook because of the lack of a long lead II … Perhaps this marked sinus arrhythmia reflects increased vagal tone? Thelin et al.

STEMI 52

STEMI Angina Myocardial Infarction Plaque 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

myocardial infarction), arrhythmias, valvular pathology, shunts, or outflow obstructions. 10 The 2014 ACC/AHA guidelines for the Management of Patients with Valvular Heart Disease , referencing this article, gives this recommendation: "CLASS IIb 1. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease.

Ischemia 52

Ischemia Cardiogenic Shock Aortic Stenosis 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Methods STEMI activations between January 2014 and April 2018 at the University of Arizona Medical Center were identified. This finding does not alter the need to pursue emergent reperfusion, although it might suggest a poorer prognosis.”[3]

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Cardiometabolic Health Congress

DECEMBER 7, 2023

These new guidelines provide necessary updates to both the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation and the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation.

Atrial Fibrillation 111

Atrial Fibrillation Risk Factors Ablation Strokes 111

DAIC

MARCH 5, 2024

a global leader in cardiac arrhythmia treatment and part of Johnson & Johnson MedTech , today announced European CE mark approval of the VARIPULSE Platform for the treatment of symptomatic drug refractory recurrent paroxysmal atrial fibrillation ( AF ) using pulsed field ablation (PFA). [ii] EMJ Cardiol. 2019; 7[1]:110-118. 6: 213-220.

Ablation 59

Ablation Atrial Fibrillation Atrial Flutter Pulmonary 59

Heart BMJ

APRIL 25, 2024

Methods This retrospective cohort study identified patients with COPD using administrative data from Alberta, Canada from 2014 to 2019. The primary outcome was the composite of all-cause death or a first hospitalisation for acute coronary syndrome, heart failure (HF), arrhythmia or cerebral ischaemia.

Pulmonary 52

Pulmonary Heart Failure Risk Factors Arrhythmia 52