Ken Grauer, MD

SEPTEMBER 6, 2024

You are shown the ECG in Figure-1 — told only that the patient had a “continuous" tachycardia. PEARL # 4: This less common form of "fast-slow" AVNRT that is illustrated in Figure-3 — has also been known as an "incessant" tachycardia. QUESTIONS: How would YOU interpret the ECG in Figure-1 ? What is the differential diagnosis?

Blog 98

Blog Tachycardia Ablation 98

Dr. Smith's ECG Blog

OCTOBER 25, 2022

We see a regular tachycardia with a narrow QRS complex and no evidence of OMI or subendocardial ischemia. The differential of a regular narrow QRS tachycardia is sinus tachycardia, SVT, and atrial flutter with regular conduction. Now the patient is in sinus tachycardia. Her initial EKG is below. Same as initial ECG.

Tachycardia 52

Tachycardia Atrial Flutter Dysrhythmia Ablation 52

Dr. Smith's ECG Blog

MAY 14, 2022

Here is his ED ECG: Regular Wide Complex Tachycardia at a rate of 229 First : What do you want to do? Before getting into analysis, a regular wide complex tachycardia could be 1. ventricular tachycardia ( VT ) or 2. AV reciprocating tachycardia ( AVRT , antidromic WPW) or 3. Next : What do you think is the ECG diagnosis?

Tachycardia 52

Tachycardia Electrophysiology Blog Ablation 52

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 ). Meyers and Smith illustrate 20 example cases vs "look-alikes" of Swirl ( with my synthesis of "Swirl" ECG findings in My Comment on that post ) from October 15, 2022.

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

APRIL 24, 2022

The ECG there reportedly showed an irregular tachycardia, and the patient was immediately referred to the emergency room. Here is her ECG on arrival: There is a wide complex tachycardia that is irregularly irregular (this is difficult to determine at these very high rates). Vitals were within normal limits other than heart rate.

AFIB 52

AFIB Tachycardia Atrial Fibrillation Blog 52

Dr. Smith's ECG Blog

MAY 10, 2023

A 34 yo woman with a history of HTN, h/o SVT s/p ablation 2006, and 5 months post-partum presented with intermittent central chest pain and SOB. That said, against acute PE — is the inconstancy of this patient's symptoms — the lack of tachycardia — and the lack of any other ECG signs of acute RV strain. This was sent by a colleague.

Coronary Angiogram 52

Coronary Angiogram Chest Pain Stenosis STEMI 52

Circulation: Arrhythmia and Electrophysiology

DECEMBER 20, 2024

BACKGROUND:Patients undergoing first-time atrial fibrillation (AF) ablation can benefit from targeting non-pulmonary vein (PV) triggers. Preprocedural identification of high-risk individuals can guide planning of ablation strategy. Among all first-time AF ablations, 68.1% were intermediate-risk (score 2, 10.5% risk), and 14.1%

Atrial Fibrillation 40

Atrial Fibrillation Ablation Electrophysiology Tachycardia 40

Frontiers in Cardiovascular Medicine

NOVEMBER 24, 2024

Currently, ethanol infusion of vein of Marshall (EIVOM) for AF ablation in HF patients remains significantly limited.MethodThis was a non-randomized, single-center, retrospective observational study. AF patients received 4-step ablation composed of EIVOM, pulmonary vein isolation (PVI) and linear ablation. vs. 93.9%).

Atrial Fibrillation 59

Atrial Fibrillation Heart Failure Ablation Pulmonary 59

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

During observation in the ED the patient had multiple self-terminating runs of Non-Sustained monomorphic Ventricular Tachycardia (NSVT). The patient has been scheduled for a PVC ablation procedure. This patient very likely has some form of idiopathic ventricular tachycardia. Potassium and magnesium serum levels were normal.

Tachycardia 72

Tachycardia Arrhythmia Ablation Atrial Flutter 72

Dr. Smith's ECG Blog

NOVEMBER 3, 2024

The CASE Continues: The patient had many episodes of NSVT ( Non-Sustained Ventricular Tachycardia ) — like th e one shown below in Figure-6. See "Lesson #3" in My Comment at the bottom of the page of the April 2, 2022 post for more on the diagnostic value of fusion beats ).

Electrophysiology 65

Electrophysiology Pacemaker Physiology Tachycardia 65