Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

While on telemetry monitoring he suffered cardiac arrest and was resuscitated. What ECG finding may have contributed to (or precipitated) the cardiac arrest? Learning points : Takotsubo can lead to cardiac arrest from ventricular arrhythmia. There are no clear signs of OMI. There is a prolonged QTc.

Cardiac Arrest 68

Cardiac Arrest Cardiomyopathy Arrhythmia Atrial Fibrillation 68

Dr. Smith's ECG Blog

JULY 21, 2024

There was no evidence bradycardia leading up to the runs of PMVT ( as tends to occur with Torsades ). If there had been — a temporary atrial pacemaker could have been considered as a way of increasing the heart rate to suppress a bradycardia-dependent arrhythmia ("overdrive pacing").

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

NOVEMBER 24, 2017

The rule of thumb is less accurate, and the risk is higher because a long QT in the presence of bradycardia ("pause dependent" Torsades) predisposes to Torsades. 6) Use a different rule of thumb for bradycardia : Manually approximate both the QT and the RR interval. 3) At heart rates below 60, far more caution is due.

Bradycardia 52

Bradycardia Article Atrial Fibrillation Chest Pain 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

For now, the 2017 AHA/ACC/HRS guidelines for asymptomatic patients that have inducible types of Brugada syndrome recommend observation without any specific therapies or interventions [8]. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death.

Heart Rhythm 52

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

DECEMBER 5, 2019

Further history later: This patient personally has no further high risk features (syncope / presyncope), but her mother had sudden cardiac arrest in sleep. This is based on the Sieira et al, 2017, risk calculator , which gives a borderline risk score (2).

Sudden Cardiac Death 52

Sudden Cardiac Death Heart Rhythm Article Tachycardia 52

Dr. Smith's ECG Blog

JANUARY 21, 2023

This ECG shows a sinus bradycardia with a normal conduction pattern (normal PR, normal QRS, and normal QTc), normal axis, normal R-wave progression, normal voltages. Hypothermia can also produce bradycardia and J waves, with a pseudo-STEMI pattern. CMAJ 2017 Vassallo SU, Delaney KA, Hoffman RS, et al. What do you think?

STEMI 52

STEMI Bradycardia Arrhythmia Cardiac Arrest 52

Dr. Smith's ECG Blog

FEBRUARY 10, 2025

Theres sinus bradycardia, borderline PR interval, narrow QRS; normal axis/R wave progression; low precordial voltages, and subtle peaked T waves (most obvious in V2, but all T waves are symmetric with a narrow base). Theres no prior ECG to compare - but the bradycardia, prolonged PR and peaked T waves could all be from hyperkalemia.

Bradycardia 118

Bradycardia Cardiac Arrest Hypertension ICU 118