2014 Arrhythmia Ischemia 
Ken Grauer, MD
MARCH 29, 2023
While medical trial of an antiarrhythmic agent can at times be undertaken ( assuming the clinician remains at the bedside throughout the process ) — synchronized cardioversion is often favored for treatment of AFib with WPW, given the exceedingly rapid ventricular response with this arrhythmia. What do YOU see?
Dr. Smith's ECG Blog
NOVEMBER 4, 2022
His response: “subendocardial ischemia. Smith : It should be noted that, in subendocardial ischemia, in contrast to OMI, absence of wall motion abnormality is common. With the history of Afib, CTA abdomen was ordered to r/o mesenteric ischemia vs ischemic colitis vs small bowel obstruction. Anything more on history?
Ken Grauer, MD
OCTOBER 13, 2023
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. For those with a special interest in cardiac arrhythmias — READ ON! —
Dr. Smith's ECG Blog
NOVEMBER 19, 2016
DISCUSSION: The 12-lead EKG EMS initially obtained for this patient showed severe ischemia, with profound "infero-lateral" ST depression and reciprocal ST elevation in lead aVR. The ECG cannot diagnose the etiology of ischemia; it only the presence of ischemia, from whatever etiology.
Dr. Smith's ECG Blog
OCTOBER 24, 2018
This was clearly severe subepicardial ischemia causing ST Elevation, but it was not of a long enough duration to result in measurable infarct. Although there is no long lead rhythm strip — it is noteworthy that there is marked sinus arrhythmia in ECG #1. But maybe not. You can see the deficiency of the definition of MI. Thelin et al.
Dr. Smith's ECG Blog
OCTOBER 13, 2022
2] Conduction through the accessory pathway can be intermittent (with different degrees of pre-excitation), and affected by ischemia. 3] So a patient with WPW can have the pattern induced by ischemia, and there is also a report of a patient with pre-existing WPW which was “ablated” by myocardial infarction after an LAD occlusion.[4]
Ken Grauer, MD
OCTOBER 27, 2023
This suggests ischemia of uncertain duration. 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. There is deep, symmetric T wave inversion with a prolonged QTc interval in anterior leads V1,V2,V3.
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