Dr. Smith's ECG Blog

JULY 5, 2018

My Comment , by K EN G RAUER, MD ( 7/5/2018 ): This blog post provides an excellent example of how a patient with SSS ( = S ick S inus S yndrome ) may present. Many patients have a T achy- B rady syndrome in which tachyarrhythmias ( most commonly rapid AFib ) alternate with periods of bradycardia. second in duration.

Atrial Fibrillation 52

Atrial Fibrillation AFIB Bradycardia Pacemaker 52

Ken Grauer, MD

APRIL 26, 2024

This defines the rhythm as AFib ( A trial F ibrillation ) , here with a controlled ventricular response ( ie, overall heart rate between ~70-to-100/minute ). P waves are absent. A cknowledgment : My appreciation for this case that is anonymously contributed. =

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Blog STEMI Aneurysm AFIB 155

Dr. Smith's ECG Blog

JULY 5, 2024

At the time, it seemed that virtually all cardiac patients with chronic AFib or heart failure were on this medication. IV Digoxin may begin to slow the ventricular response of AFib or AFlutter sooner than many clinicians realize. Smith — the choice of IV Digoxin was appropriate and effective in today's case.

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Atrial Flutter Tachycardia Atrial Fibrillation AFIB 112

Dr. Smith's ECG Blog

FEBRUARY 18, 2024

The April 6, 2023 post — excessive baseline artifact misdiagnosed as AFib ( instead of sinus rhythm with AV Wenckebach — as in Figure-4 in this post ). The January 30, 2018 post — for PTA. The January 15, 2024 post — for an OMI despite lots of artifact! The September 15, 2023 post — for PTA ( Pulse-Tap Artifact ).

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Pacemaker Blog Atrial Fibrillation Electrophysiology 109

Dr. Smith's ECG Blog

AUGUST 17, 2022

The rhythm is rapid AFib. These are the "Take-Home" Lessons from today's tracing: As per Dr. Smith — Rapid AFib may sometimes simulate acute posterior OMI. This anterior ST depression often resolves ( or at least greatly decreases ) when AFib is controlled and the heart rate slows. The July 29, 2018 post ( LA-RA reversal ).

Atrial Fibrillation 52

Atrial Fibrillation Ischemia AFIB Tachycardia 52

Dr. Smith's ECG Blog

DECEMBER 26, 2023

That said — distinction between "classic" HCM vs the apical HCM form may be useful because: i ) ECG findings tend to be different ( Lyon et al — Europace 20:102-112iii, 2018 ) ; — ii ) Echo appearance is different when hypertrophy localizes to the apex; and , iii ) There is a significantly greater incidence of AFib with apical HCM.

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Chest Pain Cardiomyopathy Blog AFIB 93

Dr. Smith's ECG Blog

APRIL 24, 2022

Patient was referred to electrophysiologic testing due to suspicion of afib and WPW. During electrophysiologic testing AVRT was induced, which degenerated to afib with ortho and antidromic conduction. Despite the near regularity in places — the reasons I immediately thought of WPW with very rapid AFib were i ) As per per Drs.

AFIB 52

AFIB Tachycardia Atrial Fibrillation Blog 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Other Arrhythmias ( PACs, PVCs, AFib, Bradycardia and AV conduction disorders — potentially lethal VT/VFib ). Sinus Tachycardia ( common in any trauma patient. ).

Tachycardia 115

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia 115

Dr. Smith's ECG Blog

DECEMBER 16, 2018

For example: Statistical likelihood that the regular WCT in ECG #1 might be AFlutter ( instead of VT ) is greatly increased in a patient with AFib who is taking Flecainide. The underlying rhythm is AFib ( irregularly irregular QRS without P waves ). Note QRS widening for beats #14-thru-18 in ECG #3.

Tachycardia 52

Tachycardia Atrial Flutter AFIB Atrial Fibrillation 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

With the history of Afib, CTA abdomen was ordered to r/o mesenteric ischemia vs ischemic colitis vs small bowel obstruction. Can J of Cardiol 2018, 34: 132-145 Here are some other cases: LVH, LBBB, RBBB, and RVH may manifest ST depression without any ischemia! See this case: what do you think the echocardiogram shows in this case?

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

Other Arrhythmias ( PACs, PVCs, AFib, Bradycardia and AV conduction disorders — potentially lethal VT/VFib ). 72; Issue 9; 2018 ) — A ) Brugada-1 ECG pattern, showing coved ST-segment elevation ≥2 mm in ≥1 right precordial lead, followed by a negative T-wave. — Sinus Tachycardia ( common in any trauma patient. ).

Arrhythmia 52

Arrhythmia Blog Chest Pain Cardiac Arrest 52

DAIC

MARCH 28, 2024

"Based on the results from the admIRE clinical trial, we are confident that this innovation has the promise to deliver significant value and differentiated capabilities, and become an important tool for the treatment of AFib." 2,3 Approximately 1 in 4 adults over the age of 40 are at risk for developing AFib. In the U.S.,

Atrial Fibrillation 110

Atrial Fibrillation AFIB Ablation Pulmonary 110

DAIC

FEBRUARY 7, 2024

billion on cardiovascular disease from 2018 to 2019, including costs from health care services, medicines, and lost productivity due to death. The framework outlines opportunities for the broader integration of the technology into the workflow for screening and diagnosing cardiovascular disease, using AFib and Hypertension as examples.

Technology 116

Technology Cardiovascular Disease Best Practices AFIB 116

Stroke Journal

FEBRUARY 1, 2024

Detailed clinical, laboratory and multimodal imaging data from known AF patients consecutively admitted to 20 stroke centers with an IS between 1/2018-12/2019 were used to define characteristics of AIS-despite-AC and compared to AIS-off-AC.Results:Out of 4456 patients with known AF prior to the AIS, 2051 (46%) were using anticoagulants.

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AFIB Strokes Stroke Embolism 40

CardiacWire

JANUARY 28, 2024

Amarin’s fish oil-based Vascepa (icosapent ethyl, aka IPE) made its mark in 2018’s REDUCE-IT trial after achieving a 25% MACE reduction among high-risk statin users, and new post hoc analysis of the same data suggests that IPE might have an even greater benefit among patients who recently had acute coronary syndrome (ACS).

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Angina AFIB Strokes Stroke 69

Dr. Smith's ECG Blog

JUNE 14, 2024

The April 6, 2023 post — excessive baseline artifact misdiagnosed as AFib ( instead of sinus rhythm with AV Wenckebach — as in Figure-4 in this post ). The January 30, 2018 post — for PTA. The January 15, 2024 post — for an OMI despite lots of artifact! The September 15, 2023 post — for PTA ( Pulse-Tap Artifact ).

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Atrial Fibrillation Tachycardia Blog Chest Pain 81

EMS 12-Lead

APRIL 28, 2022

The QRS is wide in B — but the rhythm is irregularly irregular with no sinus P waves — so this most probably represents rapid AFib with an atypical RBBB/LPHB morphology. We now see that QRS morphology in lead II during sinus rhythm is similar to the QRS morphology in lead II during rapid AFib (beats #1-5 in lead II in A).

Tachycardia 52

Tachycardia AFIB Arrhythmia Coronary Artery Bypass Graft 52

Dr. Smith's ECG Blog

MAY 3, 2024

Despite the irregularity of QRS complexes — this rhythm is not AFib — because at least some definite P waves are present ( RED arrows that I added at the bottom of ECG #1 ). Smith has noted — recognition of Shark Fin morphology told us that the seemingly wide and irregular rhythm in Figure-1 was almost certain to be supraventricular!

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Cardiogenic Shock Cardiac Arrest Hospital Ischemia 126

Dr. Smith's ECG Blog

JANUARY 15, 2024

The April 6, 2023 post — excessive baseline artifact misdiagnosed as AFib ( instead of sinus rhythm with AV Wenckebach — as in Figure-4 in this post ). The January 30, 2018 post — for PTA. Smith's ECG Blog that I have not yet included here. ). The September 15, 2023 post — for PTA ( Pulse-Tap Artifact ).

Chest Pain 64

Chest Pain Blog Arrhythmia Critical Care 64

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

Atrial Flutter Mimicking ST Depression Inferolateral ST elevation, vomiting, and elevated troponin My Comment by K EN G RAUER, MD ( 11/26/2018 ): Excellent discussion by Drs. Atrial Flutter with Inferior STEMI? What is the Diagnosis? Meyers and Smith — in which they have covered numerous aspects of this case in superb detail!

Ischemia 52

Ischemia Atrial Flutter Arrhythmia Tachycardia 52

Dr. Smith's ECG Blog

JANUARY 26, 2020

Is This a Simple Right Bundle Branch Block? == MY Comment , by K EN G RAUER, MD ( 1/26/2020 ): == Dr. Smiths ECG Blog has presented too-numerous-to-count cases of hyperkalemia ( See My Comment in the 12/11/2018 post there are many others! ). large boxes, but then decreases and remains slightly irregular ).

Bradycardia 52

Bradycardia Ischemia Cardiac Arrest AFIB 52

Dr. Smith's ECG Blog

NOVEMBER 23, 2024

The April 6, 2023 post — excessive baseline artifact misdiagnosed as AFib ( instead of sinus rhythm with AV Wenckebach — as in Figure-4 in this post ). The January 30, 2018 post — for PTA. The January 15, 2024 post — for an OMI despite lots of artifact! The September 15, 2023 post — for PTA ( Pulse-Tap Artifact ).

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Blog Chest Pain Myocardial Infarction Critical Care 63