Dr. Smith's ECG Blog

DECEMBER 13, 2024

NOTE: The ECGs in today's case are recorded in the Cabrera Format ( See Dr. Grauer Comment in the October 26, 2020 post of Dr. Smith's ECG Blog for review on the Cabrera Format ). The 2019 ESC Guidelines for the management of patients with supraventricular tachycardia indicated that IV Amiodarone should not be considered in these populations.

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AFIB Atrial Fibrillation Tachycardia Blog 103

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

Dr. Smith's ECG Blog

JULY 21, 2024

This progressed to electrical storm , with incessant PolyMorphic Ventricular Tachycardia ( PMVT ) and recurrent episodes of Ventricular Fibrillation ( VFib ). As I review in My Comment in the January 16, 2020 post of Dr. Smith's ECG Blog ( and have reproduced in Figure-2 below ) — the ECG of patients with acute LMCA occlusion may be varied.

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Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

JANUARY 8, 2024

A man in his 30s with cardiac arrest and STE on the post-ROSC ECG == MY Comment , by K EN G RAUER, MD ( 12/31 /2023 ): == My only hope about today's tragic case — is that the involved providers learn from mistakes made. KEY Findings in ECG #1 include the following: Sinus tachycardia at ~110/minute. Junctional tachycardia? ).

Chest Pain 71

Chest Pain Pulmonary Embolism STEMI 71

Dr. Smith's ECG Blog

NOVEMBER 11, 2022

There is sinus tachycardia (do not be fooled into thinking this is VT or another wide complex tachycardia!) Plus recommendations from a 5-member panel on cardiac arrest. This feature is invaluable for assessing QRS morphology with wide tachycardias in the differentiation between SVT vs VT rhythms. Eur Heart J.

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Chest Pain Cardiogenic Shock Tachycardia Ischemia 52

Dr. Smith's ECG Blog

MAY 5, 2022

After initiating treatment for hyperkalemia, repeat ECG showed resolution of Brugada pattern: The ECG shows sinus tachycardia. Steve, what do you think of this ECG in this Cardiac Arrest Patient?" A woman in her 50s with dyspnea and bradycardia A patient with cardiac arrest, ROSC, and right bundle branch block (RBBB).

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Chest Pain Bradycardia Cardiac Arrest STEMI 52

Dr. Smith's ECG Blog

FEBRUARY 27, 2023

Descriptive analysis of the ECG in today's case reveals a regular, narrow tachycardia at ~130/minute , without clear sign of sinus P waves. But the rate is ~130/minute — which is a bit fast for sinus tachycardia. So IF this is sinus tachycardia with a sinoventricular rhythm — then we have to explain WHY the rate is this fast.

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Tachycardia Document Blog Bradycardia 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. There is sinus tachycardia at ~100/minute. As often emphasized by Dr. Smith — sinus tachycardia is not a common finding with acute OMI unless something else is going on (ie, cardiogenic shock ). As per Dr.

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Chest Pain STEMI Pulmonary Embolism 73

Dr. Smith's ECG Blog

SEPTEMBER 7, 2020

Here is his 12-lead: There is a wide complex tachycardia with a rate of 257, with RBBB and LPFB (right axis deviation) morphology. Read about Fascicular VT here: Idiopathic Ventricular Tachycardias for the EM Physician Case Continued He was completely stable, so adenosine was administered. See Learning point 1 below. Arch Intern Med.

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Tachycardia Heart Disease Dysrhythmia Ablation 52

Dr. Smith's ECG Blog

OCTOBER 11, 2020

Other than tachycardia, Other than slight tachycardia, vitals were within normal limits (including oxygen saturation). About two hours after admission, he suffered a cardiac arrest (whether it was VF/VT or PEA is not available) and expired. The rhythm in ECG #1 is sinus tachycardia at 115-120/minute.

Chest Pain 52

Chest Pain STEMI Blog Tachycardia 52

Dr. Smith's ECG Blog

JULY 27, 2023

His prehospital ECG showed "inferior" ST depression and high voltage, with tachycardia. I suspected no OMI, that this could be due to LVH plus tachycardia. Conclusion: Type II MI probable due to hypoxia and tachycardia from resp arrest and amphetamine use. On arrival to the ED, the patient was diaphoretic, tachycardic.

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Tachycardia Ischemia Cardiac Arrest Echocardiogram 52

All About Cardiovascular System and Disorders

OCTOBER 26, 2023

2020 Sep;31(9):2474-2483. Type 2/3 ECG which gets converted to type 1 pattern with sodium channel blockers have 2 points. Rattanawong P, Kewcharoen J, Kanitsoraphan C, Vutthikraivit W, Putthapiban P, Prasitlumkum N, Mekraksakit P, Mekritthikrai R, Chung EH. J Cardiovasc Electrophysiol. Gourraud JB, Barc J, Thollet A, Le Marec H, Probst V.

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Sudden Cardiac Death Atrial Fibrillation Electrophysiology Arrhythmia 52

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

The ECG shows sinus tachycardia, a narrow, low voltage QRS with alternating amplitudes, no peaked T waves, no QT prolongation, and some minimal ST elevation in II, III, and aVF (without significant reciprocal STD or T wave inversion in aVL). It is difficult to tell if there is collapse during diastole due to the patient’s tachycardia.

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Tachycardia Pericarditis Ultrasound Blood Pressure 40

Dr. Smith's ECG Blog

JANUARY 30, 2019

Otherwise vitals after intubation were only notable for tachycardia. An initial EKG was obtained: Computer read: sinus tachycardia, early acute anterior infarct. She was ventilated by bag-valve-mask by EMS on arrival and was quickly intubated with etomidate and succinylcholine. A rectal temperature was obtained which read 107.9

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Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

SEPTEMBER 21, 2020

Series of Prehospital ECGs Showing Reperfusion == MY Comment by K EN G RAUER, MD ( 9/21/2020 ): == I wish those cardiologists who continue to strictly adhere to STEMI millimeter criteria would begin reading Dr. Smith’s ECG Blog. MY Thoughts on ECG #1: The rhythm is sinus tachycardia at 105-110/minute. A mysterious case.

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STEMI Hospital Blog Defibrillator 52

Journal of the American Heart Association

FEBRUARY 19, 2025

BackgroundInhospital cardiac arrest (IHCA) is associated with significant morbidity and mortality. had ventricular tachycardia/ventricular fibrillation and 73.4% Journal of the American Heart Association, Volume 14, Issue 4 , February 18, 2025. The primary outcome was inhospital mortality.

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Cardiac Arrest Coronary Artery Bypass Graft Outcomes Tachycardia 45

Dr. Smith's ECG Blog

JANUARY 21, 2023

The relationship between J wave and ventricular tachycardia during Takotsubo cardiomyopathy. Internat J Arrhyth 2020 Uesako H, Fukikawa H, Hashimoto S, et al. The final letter in the SLOWED mnemonic is " D " for "Dead" ( resulting from VT/VF or asystolic cardiac arrest ).

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STEMI Bradycardia Arrhythmia Cardiac Arrest 52

Dr. Smith's ECG Blog

JANUARY 11, 2025

It is a wide complex regular tachycardia at a rate of 120. Is it ventricular tachycardia? I fear that many learners would also not easily recognize where the QRS actually ends, and I fear that some may think that this is ventricular tachycardia due to inability to distinguish QRS from ST segment. The ST Elevation is NOT typical.

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Cardiogenic Shock Chest Pain Tachycardia Cardiac Arrest 137

Ken Grauer, MD

MARCH 29, 2025

This may be a sign of cardiac "stunning" following an MI or cardiac arrest ( See ECG Blog #272 for more on Causes of Low Voltage ). T wave inversion as seen in ECG #2 is not uncommon following a sustained tachyarrhythmia ( sometimes called a "Memory Effect" or "post-tachycardia" syndrome ).

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Blog Tachycardia Cardiac Arrest Download 117