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.

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Ken Grauer, MD

OCTOBER 13, 2023

With P waves labeled — Isn't it now much easier to appreciate that the atrial rhythm is quite regular ( with no more than a slight sinus arrhythmia )? P utting I t A ll T ogether : The precise mechanism of today's arrhythmia is complex and difficult to determine. For those with a special interest in cardiac arrhythmias — READ ON! —

Blog 159

Blog Arrhythmia Bradycardia Download 159

Circulation

NOVEMBER 29, 2023

Additional relevant studies, published through November 2022, during the guideline writing process, were also considered by the writing committee and added to the evidence tables, where appropriate.StructureAtrial fibrillation is the most sustained common arrhythmia, and its incidence and prevalence are increasing in the United States and globally.

Atrial Fibrillation 76

Atrial Fibrillation Risk Factors Ablation Arrhythmia 76

Dr. Smith's ECG Blog

JULY 24, 2024

And regarding arrhythmias: For more on the regular WCT — See My Comment in the May 5, 2020 post and in the April 15, 2020 post in Dr. Smith's ECG Blog. 11:35 — My views on: Will the computer ever be able to interpret complex arrhythmias? 14:45 — Using my definition — Are YOU an “ expert ” ECG interpreter? What are the problems?

Arrhythmia 52

Arrhythmia Blog Tachycardia CME 52

DAIC

FEBRUARY 2, 2024

milla1cf Fri, 02/02/2024 - 17:18 February 2, 2024 — GE HealthCare (Nasdaq: GEHC) announces the latest innovation in electrophysiology (EP), the Prucka 3 with CardioLab EP Recording system, to help clinicians in the diagnosis and treatment of cardiac arrhythmias. 2022 May, 79 (19) 1932–1948. million in Europe by 2060. [2]

Electrophysiology 101

Electrophysiology Innovation AFIB Atrial Fibrillation 101

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

Sci 5[4] 268-270, 2015 ) both highlight a likely association between acute development of ischemic J waves — and high risk of developing malignant ventricular arrhythmias ( My Comment in the September 23, 2020 post ).

Blog 138

Blog Cardiac Arrest Atrial Fibrillation Bradycardia 138

Dr. S. Venkatesan MD

MARCH 19, 2024

Massie Block -Ref 1) But, if there is something unusual in the clinical history, be ready to investigate until the arrhythmia, or at least the anxiety disappears. 2022 Jan 5;11(1):279. Final message AV blocks, even Mobitz type 2, can occur at normal times of heightened vagal tone.( Reference 1. J Clin Med. doi: 10.3390/jcm11010279.

Arrhythmia 52

Arrhythmia Sudden Cardiac Death Electrophysiology Cardiomyopathy 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Retrieved July 2, 2022, from [link] Moyé, D. Retrieved July 2, 2022, from [link] Sybrandy, K. Retrieved July 2, 2022, from [link] == MY Comment , by K EN G RAUER, MD ( 2/4 /2024 ): == Today's case by Dr. The ST-T wave in leads V5,V6 looks to be disproportionately large ( ie, hyperacute ) given QRS amplitude in these leads.

Tachycardia 115

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia 115

DAIC

FEBRUARY 7, 2024

This new document builds off of the previously published Best Practices for Consumer Cardiovascular Technology Solutions in January 2022. Cardiovascular disease is the leading cause of death globally, taking an estimated 695,000 lives in 2021 in the United States, about 1 in every 5 deaths, according to the CDC.

Technology 116

Technology Cardiovascular Disease Best Practices AFIB 116

Dr. Smith's ECG Blog

OCTOBER 23, 2023

2022 Jul;27(4):e12939. Epub 2022 Feb 11. T-wave alternans and the susceptibility to ventricular arrhythmias. Chronic amiodarone evokes no torsade de pointes arrhythmias despite QT lengthening in an animal model of acquired long-QT syndrome. Ann Noninvasive Electrocardiol. doi: 10.1111/anec.12939. 2007 Oct;30(10):1267-72.

Tachycardia 131

Tachycardia Cardiac Arrest ICU Blog 131

Dr. Smith's ECG Blog

SEPTEMBER 11, 2024

Other cardiac-related causes for syncope associated with acute MI may include malignant ventricular arrhythmias and bradyarrhythmias including AV block. The "good news" — is that a cardiac-related cause of syncope is unlikely if the initial ECG is normal, and cardiac monitoring in the ED fails to reveal significant arrhythmia.

Chest Pain 114

Chest Pain Aneurysm Stent Stents 114

Frontiers in Cardiovascular Medicine

DECEMBER 13, 2023

Myocardial accumulation contributes to arrhythmia and sudden death, the most common cause of FD mortality. Here, we performed a retrospective study to evaluate current ILR utilisation in FD and quantify the burden of arrhythmia that was detected, which resulted in a modification of therapy.

Arrhythmia 56

Arrhythmia Tachycardia Cardiomyopathy 56

Journal of the American Heart Association

DECEMBER 24, 2024

BackgroundThis realworld evidence study compared risks of cardiovascular events in hospital settings among patients with chronic kidney disease (CKD) with and without hyperkalemia.Methods and ResultsAdults with CKD stages 3b/4 with and without hyperkalemia were identified from Optum's deidentified Market Clarity Data (January 2016August 2022).

Kidney Disease 45

Kidney Disease Arrhythmia Myocardial Infarction Atrial Fibrillation 45

Open Heart

SEPTEMBER 18, 2024

Introduction Wearable cardioverter-defibrillators (WCD) have emerged as a valuable tool in the management of patients at risk for life-threatening arrhythmias. Methods From November 2022 to May 2024, we conducted an outpatient follow-up of 41 patients receiving WCD. Among these, 12 patients (29%) underwent ICD implantation.

Defibrillator 52

Defibrillator Sudden Cardiac Death Arrhythmia Outpatient 52

Dr. Smith's ECG Blog

AUGUST 14, 2024

[link] == MY Comment , by K EN G RAUER, MD ( 8/5 /2024 ): == As one who has been fascinated by cardiac arrhythmias for decades — I find the most difficult aspect of rhythm interpretation for me, is distinguishing between what is "real" vs what is artifact, or simply background "noise". We learn best when we learn from each other.

Arrhythmia 110

Arrhythmia Pacemaker Outcomes Blog 110

Dr. Smith's ECG Blog

JUNE 23, 2024

This is a critically important determination because of the 2017 AHA/ACC/HRS Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death.

Chest Pain 118

Chest Pain Cardiac Arrest Sudden Cardiac Death Blog 118

Dr. Smith's ECG Blog

OCTOBER 3, 2023

I thought it would be informative to break down today's rhythm — with my goal of illustrating a series of helpful techniques applicable to time-efficient interpretation of any complex arrhythmia. Take another LOOK at the 3 rhythm strips in Figure-1 : QUESTION: How would YOU begin to assess today's complex arrhythmia?

Arrhythmia 117

Arrhythmia Pacemaker Blog 117

Frontiers in Cardiovascular Medicine

FEBRUARY 17, 2025

Upper limit skin-to-skin time and missed FPI resulted predictors of the primary endpoint.ConclusionThis standardized workflow resulted in low procedural times and arrhythmias recurrence without compromising the safety. The primary endpoint was achieved by 9% and 12% of cases at 12 and 24 month follow up, respectively.

Atrial Fibrillation 52

Atrial Fibrillation Ablation Laboratory Electrophysiology 52

Journal of the American Heart Association

FEBRUARY 23, 2024

BackgroundImplantable loop recorders (ILRs) are increasingly placed for arrhythmia detection. Journal of the American Heart Association, Ahead of Print. However, historically, ≈75% of ILR alerts are false positives, requiring significant time and effort for adjudication. ILR programming was customized on the basis of implant indication.

Arrhythmia 45

Arrhythmia Hospital Outcomes 45

Circulation: Arrhythmia and Electrophysiology

MARCH 1, 2024

Circulation: Arrhythmia and Electrophysiology, Ahead of Print. The aim of this study is to define the diagnostic yield of a large gene panel with ACMG variant classification and to assess prognosis of SCN5A and non-SCN5A variants.METHODS:All patients with BrS, were prospectively enrolled in the UZB registry between 1992 and 2022.

Arrhythmia 45

Arrhythmia Electrophysiology Circulation 45

Frontiers in Cardiovascular Medicine

DECEMBER 13, 2023

The individual relationship between fatal arrhythmias and cardiac function abnormalities in predicting cardiac death risk has rarely been explored. All included ACP patients were recruited in 2009 at Yonsei University Hospital and were followed up until 2022. Results During half of the follow-up period (6.5 years), 11 patients died.

Chest Pain 64

Chest Pain Cardiac Arrest Public Health Defibrillator 64

DAIC

JUNE 19, 2024

By 1909 ECGs were being used to diagnose cases of arrhythmia; by 1910 to diagnose indicators of a heart attack. In April 2022 BMS had received FDA approval for Camzyos, the first drug developed specifically for targeting HCM. For example, in March 2023 Bristol Myers Squibb (BMS) partnered with Viz.ai How Has Funding Progressed?

AFIB 105

AFIB Reimbursement Research Atrial Fibrillation 105

Frontiers in Cardiovascular Medicine

JANUARY 10, 2024

Methods We retrospectively analyzed data of 171 consecutive patients treated for OHCA using ECPR in our cardiac arrest center from the years 2016 to 2022. The primary reason for OHCA was an acute coronary event (72%) followed by primary arrhythmia (9%) and non-ischemic cardiogenic shock (6.7%).

Cardiac Arrest 59

Cardiac Arrest Cardiogenic Shock Hospital Arrhythmia 59

Dr. Smith's ECG Blog

JANUARY 6, 2024

Never forget that sinus tachycardia is the scariest arrhythmia. The April 17, 2022 post ( Leads V1,V2 misplacement ). The May 5, 2022 post ( LA-RA reversal ). The May 24, 2022 post ( LA-LL reversal ). The May 26, 2022 post ( LA-LL reversal ). The November 8, 2022 post ( Leads V1,V2 + Pulse-Tap Artifact ).

Blog 111

Blog Ischemia Tachycardia STEMI 111

Frontiers in Cardiovascular Medicine

FEBRUARY 7, 2024

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with a high risk of stroke. Methods From January 2019 to September 2022, a total of 354 consecutive patients with NVAF were enrolled in this cross-sectional study at the First Affiliated Hospital of Guangxi Medical University.

Atrial Fibrillation 64

Atrial Fibrillation Strokes Stroke Pulmonary 64

Dr. Smith's ECG Blog

JUNE 27, 2024

I suspect there is LA-RA Lead Reversal ( See My Comment in the August 17, 2022 post of Dr. Smith's ECG Blog for review of the effects of LA-RA reversal ). The "good news" ( from an arrhythmia interpretation perspective ) — is that we now see P waves much better than we did in the initial ECG. Figure-3: I've labeled ECG #3.

Blog 120

Blog Pacemaker Bradycardia Tachycardia 120

Dr. Smith's ECG Blog

JULY 16, 2024

Arrhythmia? Today’s case recalled that scenario for me, in that it features recognition of an arrhythmia that fooled ED staff into thinking the ECG was showing an acute infarction. The ED staff failed to do this — and as a result, they completely overlooked the arrhythmia. Would you give lytics? Yes, but not because of the ECG!

Atrial Flutter 59

Atrial Flutter Chest Pain Tachycardia Arrhythmia 59

Open Heart

DECEMBER 18, 2024

Methods Data collected by NHSE Specialised Services Development Programme regarding AF ablation procedures using a single-shot, pentaspline, multielectrode PFA catheter (FARAWAVE, Boston Scientific) between June 2022 and August 2024 were aggregated and analysed to examine procedural metrics, acute efficacy and safety outcomes over 3-month follow-up.

Atrial Fibrillation 52

Atrial Fibrillation Ablation Pulmonary Arrhythmia 52

Frontiers in Cardiovascular Medicine

DECEMBER 12, 2024

33 preoperative clinical features and 4 postoperative complications were collected in each group. LASSO is a regression analysis method that performs both variable selection and regularization to enhance model prediction accuracy and interpretability.

Coronary Artery Bypass Graft 52

Coronary Artery Bypass Graft Strokes Stroke Aortic 52

Frontiers in Cardiovascular Medicine

JANUARY 15, 2024

Methods We retrospectively analysed the data of 377 consecutive patients treated for OHCA using eCPR in our cardiac arrest centre from January 2016 to December 2022. We evaluated the prognostic influence of gender in patients presenting with out-of-hospital cardiac arrest (OHCA) treated with eCPR.

Cardiogenic Shock 64

Cardiogenic Shock Cardiac Arrest BMI Coronary Artery Disease 64

Dr. Smith's ECG Blog

JUNE 28, 2023

He underwent an EP study 5/10/2022 for evaluation of pre-excitation/accessory tract which found a left sided accessory pathway - he is currently in the EP study now. In my opinion — it is a mistake to interpret arrhythmias in strict "binary" fashion — since rather than "either/or" — optimal interpretation is more of a probability statement.

Tachycardia 98

Tachycardia Ultrasound Heart Disease Atrial Fibrillation 98

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

He has a family history concerning for arrhythmia. Given the circumstances of his car crash, we presume it was due to an underlying arrhythmia. He has a family history concerning for arrhythmia with his father requiring some sort of device (PPM, ICD, unclear) at a young age.

Arrhythmia 52

Arrhythmia Blog Chest Pain Cardiac Arrest 52

Dr. Smith's ECG Blog

MARCH 22, 2024

Figure-1: Details and my proposed laddergram for today's initial ECG ( See text ). == I found the rhythm in today's initial tracing serves as a "treasure chest" of advanced arrhythmia concepts for readers who love deciphering intricate rhythms. Given the R-R interval = 1160 msecs. for the first 3 beats in this tracing ).

Chest Pain 114

Chest Pain STEMI Bradycardia Ischemia 114

Journal of Cardiovascular Electrophysiology

JANUARY 28, 2024

Methods and Results Patients with symptomatic, drug-resistant paroxysmal AF for first ablation were prospectively enrolled from September 2020 to January 2022. First-pass isolation, acute pulmonary vein (PV) reconnections, 1-year arrhythmia recurrence, and major complications were assessed. vs. 53.3%, p  = .005). vs. 14.2%, p  = .246).

Atrial Fibrillation 40

Atrial Fibrillation Ablation Arrhythmia Pulmonary 40

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

There are a number of things to look for in an ECG that can hint at arrhythmia as the cause of an apparent seizure. In my experience, the pathologic finding in the above ECG is the easiest one to overlook — especially if you are in a rush and do not do a systematic review. Learning Points: LQTS can have normal QTc. mEq/L for K+ and 1.76

Tachycardia 113

Tachycardia Blog Sudden Cardiac Death Arrhythmia 113

Journal of Cardiovascular Pharmacology

DECEMBER 3, 2010

Atrial fibrillation (AF) is the most common arrhythmia in humans. Email: atan@bidmc.harvard.edu Copyright © 2022 Wolters Kluwer Health, Inc. It affects 5% of the population over the age of 65 years and is projected to rise as the population ages. Phone: 617 667 8800. Fax 617 632 7820. All rights reserved.

Atrial Fibrillation 40

Atrial Fibrillation Article Arrhythmia 40

Dr. Smith's ECG Blog

FEBRUARY 18, 2024

This could be easily overlooked since there is complete heart block, but recognizing the atrial arrhythmia may mean prescribing anticoagulation to prevent stroke. The October 21, 2022 post — for " artifactual VT". In this case, it is atrial fibrillation. Figure-1: I've labeled the artifact in today's initial ECG.

Pacemaker 109

Pacemaker Blog Atrial Fibrillation Electrophysiology 109