Dr. Smith's ECG Blog

JULY 16, 2022

The computer called "Sinus Bradycardia" only (implying that everything else is normal. The overreading Cardiologist called it only "Sinus Bradycardia" with no other findings. The rhythm in Figure-1 is sinus bradycardia and arrhythmia. These features are subtle — but they are definitely present and important to recognize.

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Chest Pain Bradycardia Blog Critical Care 52

Dr. Smith's ECG Blog

OCTOBER 15, 2024

Additionally, his cardiac telemetry monitor showed runs of accelerated idioventricular rhythm, a benign arrhythmia often associated with coronary reperfusion. He had multiple episodes of bradycardia and nonsustained ventricular tachycardia. As expected, the patient reported total resolution of pain by the time he got to the ED.

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Chest Pain STEMI Echocardiogram Stents 116

Dr. Smith's ECG Blog

JANUARY 22, 2020

There are 3 etiologies I always think of with bradycardia and AV block: 1. See this terrible case: Computer often fails to diagnose atrial fibrillation in ventricular paced rhythm, and that can be catastrophic == MY Comment , by K EN G RAUER, MD ( 1/22/2020 ): == Our THANKS to Dr. Smith for presenting this extremely interesting case.

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Pulmonary AFIB Atrial Fibrillation Pacemaker 52

Dr. Smith's ECG Blog

JUNE 23, 2023

The patient later settled into sinus bradycardia. The above said — Dr. Smith's approach to today's arrhythmia highlights a number of important points! Just because a regular WCT is VT does not necessarily mandate immediate cardioversion — IF the patient is hemodynamically stable and tolerating the arrhythmia.

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Tachycardia Cardiomyopathy Arrhythmia Diabetes 52

Dr. Smith's ECG Blog

APRIL 29, 2020

Therefore, she underwent temporary pacemaker placement and overdrive pacing at a rate of 90 bpm to keep the heart rate up in order to prevent these PVCs triggering ventricular arrhythmia. Hypokalemia was unlikely because she continued to have ventricular arrhythmia despite of correcting electrolytes.

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Cardiac Arrest Defibrillator Ischemia Tachycardia 52

Dr. Smith's ECG Blog

JULY 21, 2024

However, he suddenly developed a series of malignant ventricular arrhythmias. Below are printouts of some of the arrhythmias recorded. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation. The arrhythmia starts with a PVC having a short coupling interval.

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Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

JANUARY 26, 2020

Her vital signs were within normal limits except for bradycardia at 55 bpm. It is probably sinus bradycardia with very small/depressed P-waves and prolonged PR interval. P EARL # 4 In my opinion, it is not worth wasting time trying to figure out the specific rhythm diagnosis of a bradycardia when there is hyperkalemia.

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Bradycardia Ischemia Cardiac Arrest AFIB 52

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The arrhythmia spontaneously converted before defibrillation was achieved. Figure-1: Reasons for the varied ECG presentation of acute LMain occlusion — excerpted from Dr. Smith’s 8/9/2019 post ( This Table from My Comment in the January 16, 2020 post ). ECG #3 The above ECG shows a polymorphic VT at a rate of about 180 BPM.

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Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128

Dr. Smith's ECG Blog

JANUARY 23, 2024

VT is the second most common presenting arrhythmia. Vaso or inotropic medications are not harmless, and can precipitate life threatening arrhythmias. It is common with 2nd- and 3rd-degree AV block to see a " ventriculophasic " sinus arrhythmia. AV block is the first manifestation of CS in more than 30% of patients.

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Tachycardia Arrhythmia Heart Disease Sudden Cardiac Death 107

EMS 12-Lead

JUNE 1, 2022

plaque disruption), the T waves still manifest markings of a previous state of suboptimal coronary flow that resolved: Type II supply-demand mismatch in the setting of extreme bradycardia. Chapter 17: Ventricular Arrhythmias. 2] Although the clinical context in today’s case does not fit these descriptors for Type I OMI (e.g.

Heart Failure 52

Heart Failure Myocardial Infarction Bradycardia Chest Pain 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

Prior to Mizusawa's study, it was thought that the incidence of syncope, arrhythmia, or SCD in this cohort was low [7]. In light of the risk of arrhythmia events observed in the Mizusawa trial, a formal EP study might be reasonable to obtain in those with fever induced asymptomatic Brugada ECG changes to help risk stratify these patients.

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Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

MAY 6, 2019

Bradycardia. Finally — a detailed family history ( for early sudden death ) + a careful personal history ( for syncope/presyncope; malignant arrhythmia ) is in order. Acute febrile illness. Variations in autonomic tone. Hypothermia. Electrolyte imbalance ( hypokalemia; hyperkalemia ). Ischemia/infarction. Cardioversion/defibrillation.

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Chest Pain STEMI Ischemia Myocardial Infarction 52

Dr. Smith's ECG Blog

DECEMBER 5, 2023

A repeat ECG was performed as adult cardiology was asked to evaluate the patient for emerget PCI: Sinus bradycardia with persistent elevation in the inferior leads with reciprocal depression in aVL Patient was taken to cath lab with adult cardiology which revealed normal coronary arteries without evidence of occlusion MI. As per Drs.

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Pediatrics Pericarditis COVID-19 Congenital Heart Disease 120

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. Internat J Arrhyth 2020 Uesako H, Fukikawa H, Hashimoto S, et al.

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STEMI Bradycardia Arrhythmia Cardiac Arrest 52