Dr. Smith's ECG Blog

JULY 31, 2020

Meyers, Weingart and Smith published their OMI Manifesto — in which they extensively document the critically important concept that management of acute MI by separation into a “STEMI” vs “non-STEMI” classification is an irreversibly flawed approach.

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Dr. Smith's ECG Blog

APRIL 18, 2024

International evaluation of an artificial-intelligence- powered electrocardiogram model detecting acute coronary occlusion myocardial infarction. Immediate and early percutaneous coronary intervention in very high-risk and high-risk non-ST segment elevation myocardial infarction patients. Clin Cardiol 2022 4. Herman, Meyers, Smith et al.

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Dr. Smith's ECG Blog

DECEMBER 5, 2022

Electromechanical association: a subtle electrocardiogram artifact. Incredibly , this case was just published in Circulation on January 22, 2018 (thanks to Brooks Walsh for finding this!) 2018; 137: 402-404. 2018; 137: 402-404. Journal of Electrocardiology. 2012;45(1):15-17. doi:10.1016/j.jelectrocard.2010.12.162.

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Dr. Smith's ECG Blog

NOVEMBER 4, 2022

New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. 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! Incidence of an acute coronary occlusion.

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EMS 12-Lead

MAY 20, 2022

New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. Paroxysmal atrioventricular block: Eletrophysiological mechanism of phase 4 conduction block in the His-Purkinje system: A comparison with phase 3 block. Pacing Clin Electrophysiol. 40; 1234-1241.

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Dr. Smith's ECG Blog

FEBRUARY 15, 2018

J Electrocardiology January–February, 2018; Volume 51, Issue 1, Pages e5–e6. We have studied the value of the QRS-T angle in normal and abnormal electrocardiograms, and have noted the normal A^QRS ranges between -15^ and +85^ on the hexaxial reference system and locates centrally from normal QRS vectors that vary from -30^ to +95 ^.

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Dr. Smith's ECG Blog

FEBRUARY 13, 2023

DIagnostic accuracy oF electrocardiogram for acute coronary OCClusion resulTing in myocardial infarction (DIFOCCULT study). Eur Heart J 2018 4. Aslanger et al. Int J Cardiol Heart Vasc 2020 3. Lemkes et al. Timing of revascularization in patients with transient ST segment elevation myocardial infarction: a randomized clinical trial.

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Dr. Smith's ECG Blog

DECEMBER 15, 2023

Below is the post -PCI electrocardiogram. For more on this mirror-image opposite ST-T wave relation in leads III vs aVL — See My Comment in the March 8, 2019 and August 9, 2018 posts in Dr. Smith's ECG Blog ). In the cath lab the patient was found to have a 100% occlusion of a small 1st marginal branch of the LCx.

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Dr. Smith's ECG Blog

SEPTEMBER 30, 2019

You will note that it is essentially an unremarkable electrocardiogram except for some PACS. We have often referred to this almost magical m irror- i mage r elationship for ST-T waves in leads I II and aV L — which when present, means a cute i nferior O MI until you prove otherwise ( See My Comment on the 8/9/2018 SSmith Blog Post ).

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Dr. Smith's ECG Blog

MARCH 31, 2023

Meyers, Weingart and Smith in their 2018 OMI Manifesto. Grauer K, Kravitz L, Curry RW, Ariet M: Computerized Electrocardiogram Interpretations: Are They Useful for the Family Physician? NOTE: There is a reason the PM Cardio AI Bot app. has performed so well clinically: It has been programmed using ECG criteria put forth by Drs.

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Dr. Smith's ECG Blog

DECEMBER 27, 2018

A Deep Neural Network learning algorithm outperforms a conventional algorithm for emergency department electrocardiogram interpretation. This ECG comes from Pierre Taboulet ( [link] /)( [link] ) an ECG whiz who codes a lot of ECGs for Cardiologs' Artificial Intelligence Deep Neural Network algorithm ( [link] ). What an honor.

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Dr. Smith's ECG Blog

FEBRUARY 6, 2020

The stress electrocardiogram is non-diagnostic. For another case in which marked ST elevation in leads V1 and V2 could easily be mistaken for a hyperacute change — See the Figure I drew in My Comment at the bottom of the December 27, 2018 post on Dr. Smith’s ECG Blog. No wall motion abnormality at rest.

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Dr. Smith's ECG Blog

JUNE 2, 2023

Usefulness of the Electrocardiogram in Establishing the Diagnosis and Prognosis of Arrhythmogenic Right Ventricular Cardiomyopathy Other References, from the above article: 1 FI Marcus Epsilon waves aid in the prognosis and risk stratification of patients with ARVC/D J Cardiovasc Electrophysiol, 26 (2015), pp. J Electrocardiol, 42 (2009), pp.

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Dr. Smith's ECG Blog

OCTOBER 9, 2018

The utility of the triage electrocardiogram for the detection of ST-segment elevation myocardial infarction. October 2018. It is easy to be led astray by the computer. -- My Comment by K EN G RAUER, MD ( 10/9/2018 ): -- I agree with Dr. Smith — This is a faulty study for many reasons. This paper was just published: Noll S.

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Dr. Smith's ECG Blog

JULY 22, 2023

Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. 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. — Heart Rhythm, 13(7): 1515-1520. [2]: Circulation, 117, 1890–1893. [3]: Heart Rhythm, 4(2), 198-199. [6]

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Dr. Smith's ECG Blog

MAY 8, 2023

10 In 2018, the European Society of Cardiology guidelines 11 and the fourth universal definition of myocardial infarction 12 suggested utilizing the original Sgarbossa criteria (Figures 1A to 1C) for diagnosis of occlusion myocardial infarction in both left bundle branch block 13 , 14 and ventricular paced rhythm.15,

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EMS 12-Lead

APRIL 21, 2022

New insights into the use of the 12 Lead Electrocardiogram for diagnosing Acute Myocardial Infarction in the emergency department. Readers interested in a more robust discussion of STD vectors, and their implications in OMI, are encouraged to read this phenomenal post at the Smith ECG Blog. link] [1] Mirand, D. 2] Aslanger, E.,

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Dr. Smith's ECG Blog

JANUARY 30, 2019

Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. Heart Rhythm, 13(7): 1515-1520. [2]: 2]: Junttila MJ, Gonzalez M, Lizotte E, Benito B, Vernooy K, Sarkozy A, Huikuri HV, Brugada P, Brugada J, Brugada R. Circulation, 117, 1890–1893. [3]: Brugada electrocardiographic pattern induced by fever.

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Dr. Smith's ECG Blog

MARCH 6, 2019

Early Continuous ST Segment Monitoring in Unstable Angina: Prognostic Value Additional to the Clinical Characteristics and the Admission Electrocardiogram. American Journal of Cardiology 2018. (Patel et al., Krucoff et al.) Patel et al. Heart 1996. Krucoff et al. Blondheim et al.

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Dr. Smith's ECG Blog

DECEMBER 5, 2019

Fever not only unmasks a Brugada-type electrocardiogram (ECG) but also increases the risk of ventricular tachyarrhythmias such as ventricular fibrillation (VF) or sudden cardiac death. Heart Rhythm 2018. Studies have shown a higher prevalence of BrS in febrile patients compared to nonfebrile ones. y (3 of 88, 43.6 ± 37.4

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Frontiers in Cardiovascular Medicine

DECEMBER 22, 2024

The role of an electrocardiogram (ECG) in routine testing remains controversial in current guidelines. ObjectivesThe occurrence of sudden cardiac death (SCD) in competitive athletes has led to a discussion about appropriate preparticipation screening models. A staged preparticipation screening was performed.

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