Journal of the American Heart Association

JANUARY 12, 2024

BackgroundTelecommunicator CPR (T‐CPR), whereby emergency dispatch facilitates cardiac arrest recognition and coaches CPR over the telephone, is an important strategy to increase early recognition and bystander CPR in adult out‐of‐hospital cardiac arrest (OHCA). Journal of the American Heart Association, Ahead of Print.

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Cardiac Arrest Pediatrics Hospital 40

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). Association of Coronavirus Disease 2019 (COVID-19) With Myocardial Injury and Mortality. Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): Evidence from a meta-analysis. Guo T, Fan Y, Chen M, et al.

Cardiac Arrest 52

Cardiac Arrest COVID-19 Myocardial Infarction Cardiogenic Shock 52

Ken Grauer, MD

JUNE 14, 2024

The ECG in Figure-1 — was obtained from a middle-aged man who presented to the ED ( E mergency D epartment ) in cardiac arrest. I i llustrate the ECG finding of T-QRS-D below in Figure-3 , which I've excerpted from My Comment in the November 14, 2019 post in Dr. Smith's ECG Blog. Should you activate the cath lab?

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Blog STEMI Cardiac Arrest Tachycardia 161

Dr. Smith's ECG Blog

MAY 3, 2024

Some patients have baseline RBBB with LAFB, but in patients with likely ACS, these are associated with severe infarction with cardiac arrest, cardiogenic shock or impending shock. In Figure-1 — I reproduce major points that I've summarized from Dr. Smith's August 9, 2019 post on the subject.

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Cardiogenic Shock Cardiac Arrest Hospital Ischemia 126

Ken Grauer, MD

JULY 29, 2023

The ECG in Figure-1 was obtained from an 18-year old woman — who moments before been resuscitated from out-of-hospital cardiac arrest. Does this ECG in Figure-1 provide clue(s) to the etiology of this patient's cardiac arrest? I suspected the answer resides in the reason why an 18-year woman might have a cardiac arrest.

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Blog Cardiac Arrest Cardiomyopathy Hospital 148

Dr. Smith's ECG Blog

JUNE 21, 2023

Two hours later , the patient returned to this same urgent care facility with worsening chest pain, and this ECG was performed: While getting another ECG, the patient suffered cardiac arrest: After multiple defibrillations, ROSC was achieved with ongoing "STEMI". Clinical Cardiology 2019. Long term follow up is unavailable.

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Chest Pain Cardiac Arrest STEMI Defibrillator 98

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

We periodically review this intriguing ECG finding that is best known for its association with hypothermia — but which may also be seen in association with a number of other entities, including acute infarction and cardiac arrest. My Comment addresses a few additional aspects of this phenomenon.

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Blog Cardiac Arrest Atrial Fibrillation Bradycardia 137

Frontiers in Cardiovascular Medicine

JANUARY 9, 2024

Methods Patients who developed LVFWR following AMI and underwent surgical repair at our Institution from January 1990 to December 2019 were considered. Low cardiac output syndrome was the main cause of postoperative death. The aim of this study was to report a single-center experience in this field over a period of 30 years.

Myocardial Infarction 59

Myocardial Infarction Cardiac Arrest Risk Factors Hospital 59

Open Heart

SEPTEMBER 30, 2024

Method This is a retrospective cohort study of consecutive ambulance attendances for non-traumatic shock in Victoria, Australia (January 2015–June 2019) linked with government-held administrative data (emergency, admissions and mortality records). Predictors of 30-day mortality were assessed using Cox proportional regressions.

Cardiac Arrest 52

Cardiac Arrest Blood Pressure Outcomes Hospital 52

DAIC

JANUARY 11, 2024

Researchers analyze primary and secondary cardiovascular outcomes in 132,784 inpatients with COVID-19 (October 8, 2020 to September 30, 2021) and 31,173 inpatients with non-COVID-19 pneumonia (January 1, 2019 to December 31, 2019) in Korea. The results indicate a lower risk of cardiovascular disease in COVID-19 patients.

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COVID-19 Hospital Thrombosis Inpatient 103

Dr. Smith's ECG Blog

OCTOBER 20, 2024

This patient is actively dying from a left main coronary artery OMI and cardiac arrest from VT/VF or PEA is imminent! Complete LMCA occlusion is associated with clinical shock and/or cardiac arrest. The arterial blood gas showed a lactic acidosis with a lactate level of 17mmol/L.

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Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128

Ken Grauer, MD

JULY 9, 2023

Blood was drawn , and the patient was promptly placed in a room to be seen — but on entering, the ED physician found her unresponsive in cardiac arrest. Do you see any indication on this ECG of WHY this patient was about to arrest? Is there any indication on this ECG of WHY this patient shortly after had a cardiac arrest?

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Blog Cardiac Arrest Pulmonary AFIB 78

Heart 2023 Conference

JULY 11, 2023

Using automated external defibrillators (AEDs) and cardiopulmonary resuscitation (CPR) as soon as possible increases a person's chance of surviving a cardiac arrest. After meeting the exclusion criteria, more than 9,500 cases of out-of-hospital cardiac arrest were included in the study cohort. versus 4.6%

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Defibrillator Cardiac Arrest Heart Failure RN 52

Dr. Smith's ECG Blog

OCTOBER 25, 2023

Polymorphic Ventricular Tachycardia Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management Cardiac Arrest. A New Seizure in a Healthy 20-something More cases of long QT not measured correctly by computer (these are all fascinating ECGs/cases): Bupropion Overdose Followed by Cardiac Arrest and, Later, ST Elevation.

Chest Pain 123

Chest Pain Ischemia Cardiac Arrest Blog 123

Dr. Smith's ECG Blog

SEPTEMBER 12, 2023

Figure-2: A rapid method for estimating the QTc ( Figure from My Comment in the March 19, 2019 post in Dr. Smith's ECG Blog ). == Clinical Implications of a Short QTc: The differential diagnosis for today's tracing, with its short QTc ~360 msec. ) — but as can be seen, my estimate of ~360 msec. mg/dL — vs normal values = 4.4-5.2

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Cardiac Arrest Blog Atrial Fibrillation AFIB 68

Dr. Paddy Barrett

MAY 17, 2024

And pretty much every doctor can recall an event where a patient experienced a suddenly stressful event and had a cardiac event. That event might have been a heart rhythm issue or even a cardiac arrest. In the hours after the 911 attacks on the World Trade Centre in New York, the rates of cardiac arrest more than doubled.

Heart Disease 101

Heart Disease Heart attacks Heart Attack Risk Factors 101

Circulation

NOVEMBER 27, 2024

We provide contemporary nationwide estimates of the temporal trends of SCD in young individuals (135 years of age) from 2000 through 2019 and correlate these trends to changes in out-of-hospital cardiac arrest (OHCA) patterns, rates of inherited cardiac diseases, and implantations of implantable cardioverter defibrillators (ICD).METHODS:All

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Sudden Cardiac Death Defibrillator Cardiac Arrest Certification 49

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

We analyze the national trends in mechanical thrombectomy use and outcomes for stroke five years after publication of the US guideline update.MethodsWe analyzed the National Inpatient Sample from 2012‐2019. ICD‐9 and ICD‐10 codes identified Ischemic stroke and mechanical thrombectomy patients.

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Stroke Strokes Cardiac Arrest Inpatient 40

Dr. Smith's ECG Blog

JULY 21, 2024

Figure-2: Reasons for the varied ECG presentation of acute LMain occlusion — excerpted from Dr. Smith’s 8/9/2019 post ( See text ). == Addendum Note: Quinidine has a long history of use to treat cardiac arrhythmias and severe malaria. Figure-1: I've labeled the initial ECG in today's case. (

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Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Journal of the American Heart Association

FEBRUARY 19, 2025

We sought to describe current treatment selection patterns and hospitallevel variability.Methods and ResultsWe identified patients presenting with STEMI with a culprit lesion on coronary angiography between January 1, 2019, and March 31, 2023, using the NCDR (National Cardiovascular Data Registry) CPMI (Chest PainMyocardial Infarction) registry.

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Myocardial Infarction Hospital STEMI Cardiac Arrest 40

Circulation

NOVEMBER 11, 2024

This study evaluates the outcomes in patients admitted for HF with and without hyperkalemia.Methods:We used the Nationwide Readmissions Database (NRD) from 2016-2019, extracting adult patients with a primary diagnosis of HF who were admitted between January and November of each year. Survey procedures were applied using SAS 9.4.Results:We

Inpatient 40

Inpatient Heart Failure Outcomes Cardiac Arrest 40

Journal of the American Heart Association

JANUARY 19, 2024

Patients who had ECMO initiated within 24 hours (n=5882 [68.2%]) differed from those who had ECMO initiated after 24 hours, with younger age, more preceding cardiac arrest, and worse acidosis. Multivariable logistic regression evaluated the association between time from admission to ECMO initiation and in‐hospital death.

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Cardiogenic Shock Outcomes Cardiac Arrest Hospital 40

Circulation: Heart Failure

MARCH 8, 2024

A secondary analysis evaluated outcomes for severe HF hospitalizations (cardiogenic shock, cardiac arrest, and mechanical ventilation). Centers performing at least 1 heart transplant or left ventricular assist device were classified as ATCs. of centers), 525 037 (18.3%) were admissions to ATCs (5.5%

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Heart Failure Cardiogenic Shock Outcomes Cardiac Arrest 40

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

Osborn waves have been reported with hypercalcemia, brain injury, subarachnoid hemorrhage, Brugada syndrome, cardiac arrest from VFib — and — severe, acute ischemia resulting in acute MI ( See My Comment in the November 22, 2019 post on Dr. Smith’s Blog ). Rituparna et al — as well as Chauhan and Brahma ( Int.

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Cardiac Arrest Bradycardia Chest Pain Ischemia 40

DAIC

JANUARY 23, 2024

mg experienced a 23% lower incidence of death from cardiovascular causes, resuscitated cardiac arrest, myocardial infarction, stroke, or urgent hospitalization for angina leading to coronary revascularization in a time-to-event analysis. 2019 Sep 10;140(11):e649-e650] [published correction appears in Circulation. References: 1.

Cardiovascular Disease 111

Cardiovascular Disease Heart attacks Heart Attack Coronary Artery Disease 111

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Further research and attention to this area are crucial for improving patient outcomes and guiding clinical interventions in this challenging condition.MethodsICD‐10‐CM codes were used to query the National Inpatient Sample (NIS) for patients with AIS between 2010 and 2019. Patients with AKI were on average older (63.29

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Hemorrhage Aneurysm Cardiac Arrest Myocardial Infarction 40

Dr. Smith's ECG Blog

DECEMBER 13, 2024

The 2019 ESC Guidelines for the management of patients with supraventricular tachycardia indicated that IV Amiodarone should not be considered in these populations. Regarding AFib with WPW: The very rapid heart rate and at times extremely short R-R intervals put the patient with AFib and WPW at risk of cardiac arrest from VFib.

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AFIB Atrial Fibrillation Tachycardia Blog 103

Ken Grauer, MD

JUNE 6, 2023

Unfortunately — the patient abruptly developed hypoxemia, followed by cardiac arrest with PEA. It was thought that this action precipitated the patient's desaturation, and led to his cardiac arrest. The plan was to proceed as soon as possible with aortic valve replacement. He could not be resuscitated.

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Blog Pulmonary Hypertension Aortic 78

All About Cardiovascular System and Disorders

OCTOBER 25, 2023

But the full cohort of the CABANA trial did not show a significant reduction in the primary composite end point of death, disabling stroke, serious bleeding or cardiac arrest [7]. 2019 Apr 2;321(13):1261-1274. EAST-AFNET 4 trial had 2789 patients with early atrial fibrillation and cardiovascular conditions [8].

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Atrial Fibrillation Heart Failure Ablation Cardiac Arrest 52

Ken Grauer, MD

OCTOBER 21, 2023

Subendocardial Ischemia from another Cause ( ie, sustained tachyarrhythmia; cardiac arrest; shock or profound hypotension; GI bleeding; anemia; "sick patient" , etc. ). The January 9, 2019 post in Dr. Smith's ECG Blog ( Please scroll down to the bottom of the page to see My Comment ).

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Blog Chest Pain Ischemia STEMI 98

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Am J Med 2019, 132(5):622-630. Now there is a paper published in 2019 that proves the point beyond doubt, though makes it clear that this pattern is associated with very high mortality. American Journal of Medicine 132(5):622-630; May 2019. J Electrocardiol 2013;46:240-8 2. Harhash AA, Huang JJ, Reddy S, et al.

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Ischemia STEMI Stenosis Chest Pain 52

Dr. Smith's ECG Blog

OCTOBER 17, 2024

There was 100% proximal LAD occlusion with TIMI 0 flow, and cardiac arrest in the cath lab. Finally — Note that there is also T-QRS-D ( T erminal QRS D istortion ) in lead V3 ( See My Comment in the November 14, 2019 post for review and illustration of T-QRS-D criteria ).

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Chest Pain STEMI Pulmonary Embolism 73

Dr. Smith's ECG Blog

MAY 6, 2019

This ECG pattern may be diagnostic of B rugada S yndrome IF seen in association with: i ) a history of cardiac arrest; polymorphic VT; or of non-vagal syncope; and / or ii ) a positive family history of sudden death at an early age; and / or iii ) a similar ECG in relatives. This is not RBBB ( TOP LEFT in Figure-2 ).

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Chest Pain STEMI Ischemia Myocardial Infarction 52

Dr. Smith's ECG Blog

NOVEMBER 18, 2019

No more abnormal U-waves == MY Comment, by K EN G RAUER, MD ( 11/18/2019 ): == LOTS of great points regarding use of the ECG in association with electrolyte abnormalities. From EMCrit: Taking control of severe hyponatremia with DDAVP An ECG recorded 2 days later with a K of 4.1: Note increasing U wave amplitude ( See text ).

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Chest Pain Cardiac Arrest Bradycardia Ischemia 52

Dr. Smith's ECG Blog

SEPTEMBER 7, 2020

Not all forms of idiopathic VT are predictable based on their ECG appearance ( Anderson et al, 2019 ). Anderson et al, 2019 ) — the chest lead LBBB pattern characteristic of LVOT ( as distinguished from RVOT ) — is that transition tends to occur earlier ( ie, by V1-V2 for LVOT vs after V3 or V4 for RVOT ).

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Tachycardia Heart Disease Dysrhythmia Ablation 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Heart Rhythm, 15(9): 1394-1401. [7] 7] American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.

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Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

These include ( among others ) — acute febrile illness — variations in autonomic tone — hypothermia — ischemia-infarction — malignant arrhythmias — cardiac arrest — and especially Hyperkalemia. Patients with such conditions that may transiently mimic the ECG findings of a Brugada-1 pattern are said to have Brugada Phenocopy.

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Arrhythmia Blog Chest Pain Cardiac Arrest 52