Dr. Smith's ECG Blog

SEPTEMBER 29, 2023

It's a very "fun" ECG, with initial ectopic atrial tachycardia (negative P waves in inferior leads conducting 1:1 with the QRSs), followed by spontaneous resolution to sinus rhythm. Unfortunately the patient was erroneously diagnosed with "SVT / atrial fibrillation" and put on apixaban!!! What About the Tachycardia?

Chest Pain 129

Chest Pain Tachycardia STEMI Blog 129

Journal of Cardiovascular Electrophysiology

DECEMBER 7, 2023

Abstract Introduction The use of flecainide and propafenone for medical cardioversion of atrial fibrillation (AF) and atrial flutter/intra-atrial reentrant tachycardia (IART) is well-described in adults without congenital heart disease (CHD). The unit of analysis was each episode of AF/IART.

Congenital Heart Disease 40

Congenital Heart Disease Atrial Fibrillation Congenital Heart Disease 40

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

This strip was obtained: Apparent Wide Complex Tachycardia at a rate of 280 What do you think? Recently diagnosed with intermittent paroxysmal atrial fibrillation but no EKGs available to confirm. Troponins 34>33>43, likely secondary to myocardial injury from tachycardia. Sinus tachycardia does not go this fast.

Atrial Flutter 63

Atrial Flutter Exercise AFIB Tachycardia 63

Dr. Smith's ECG Blog

OCTOBER 21, 2022

Artifact can obscure the rhythm or cause misdiagnosis of rhythms such as atrial fibrillation, ventricular tachycardia, and ventricular fibrillation. Instead — lead III tells us that the underlying rhythm is sinus tachycardia at 100-105/minute.

Tachycardia 52

Tachycardia Atrial Fibrillation Defibrillator Blog 52

Dr. Smith's ECG Blog

AUGUST 17, 2022

ACUTE MI (I allowed Acute MI to be in the report because I knew there would be an elevated troponin from ischemia, which is the definition of acute MI -- but in this case it would most likely be a Type 2 MI from tachycardia) There is also LA-RA lead reversal. The April 17, 2022 post ( Leads V1,V2 misplacement ). She had some fractures.

Atrial Fibrillation 52

Atrial Fibrillation Ischemia AFIB Tachycardia 52

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. Adenosine worked.

Tachycardia 52

Tachycardia Atrial Flutter Dysrhythmia Ablation 52

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). Lead aVR seems to show the atrial activity clearly.

AFIB 52

AFIB Tachycardia Atrial Fibrillation Blog 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2022

Written by Bobby Nicholson MD, with edits by Meyers A woman in her 50s with past medical history of heart failure, prior stroke, atrial fibrillation on Eliquis, lung cancer in remission, and CKD, presented to the emergency department for evaluation of cough and shortness of breath. What do you think? References: 1. Khouzam RN.

Tachycardia 52

Tachycardia RN Atrial Fibrillation Cancer 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Case submitted and written by Mazen El-Baba MD, with edits from Jesse McLaren and edits/comments by Smith and Grauer A 90-year old with a past medical history of atrial fibrillation, type-2 diabetes, hypertension, dyslipidemia, presented with acute onset chest/epigastric pain, nausea, and vomiting. A normal PR interval.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 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.

Tachycardia 40

Tachycardia Pericarditis Ultrasound Blood Pressure 40

DAIC

MARCH 31, 2025

AF Often Asymptomatic: Even for atrial fibrillation (AF)the most commonly symptomatic arrhythmiaover half of all cases were asymptomatic. Its estimated that undiagnosed atrial fibrillation alone costs the U.S. $3 Published March 24, 2022. Accessed April 25, 2024. link] 5 Ataklte et al. 2013;112(8):1263-1270.

Arrhythmia 52

Arrhythmia Atrial Fibrillation Tachycardia Heart Failure 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. Circulation: Arrhythmia and Electrophysiology, Ahead of Print. Preprocedural identification of high-risk individuals can guide planning of ablation strategy.

Atrial Fibrillation 40

Atrial Fibrillation Ablation Electrophysiology Tachycardia 40

Dr. Smith's ECG Blog

JUNE 14, 2024

The team immediately paged cardiology, concerned for polymorphic ventricular tachycardia. Since sinus conducted QRS complexes cannot co-exist together with ventricular tachycardia, this must all be artifact. Such as atrial fibrillation or sinus rhythm with extrasystoles. The October 21, 2022 post — for " artifactual VT".

Atrial Fibrillation 81

Atrial Fibrillation Tachycardia Blog Chest Pain 81

Circulation

NOVEMBER 10, 2023

We performed propensity score matched (PS) analysis of LBBAP and BVP in a 1:1 ratio.

Atrial Fibrillation 40

Atrial Fibrillation Pacemaker Physiology Heart Failure 40

All About Cardiovascular System and Disorders

OCTOBER 26, 2023

Still more are factors are age < 18 years, sudden cardiac death in first degree relative, SCN5A mutations, atrial fibrillation, PR interval > 200 ms, QRS duration > 120 ms, presence of late potentials and aVR sign, manifested as R wave ≥ 0.3 2022 Mar;8(3):386-405. Atrial fibrillation and Brugada syndrome.

Sudden Cardiac Death 52

Sudden Cardiac Death Atrial Fibrillation Electrophysiology Arrhythmia 52

Dr. Smith's ECG Blog

OCTOBER 10, 2022

The rhythm is atrial fibrillation. If you use quantitative end-tidal CO2 monitoring, there is never any need to waste time making sure that the endotracheal tube is correctly placed. == MY Comment, by K EN G RAUER, MD ( 10/10/2022 ): == Today’s case is a “Save”! The QRS complex is within normal limits.

Cardiac Arrest 52

Cardiac Arrest Chest Pain Embolism Pulmonary 52

Frontiers in Cardiovascular Medicine

NOVEMBER 24, 2024

BackgroundIn medical practice, atrial fibrillation (AF) is intricately associated with heart failure (HF). The primary composite endpoint was defined as recurrence of atrial tachycardia over 30 s. 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

MARCH 3, 2025

The status of the patients chest pain at this time is unknown : EKG 1, 1300: There is sinus tachycardia and artifact of low and high frequency. However, there is also significant tachycardia , with heart rate of 116, and known hypoxia. increasing stenosis, ischemia, volume changes, increased blood pressure, atrial fibrillation, etc.)

Tachycardia 73

Tachycardia Pulmonary Chest Pain Stenosis 73

Dr. Smith's ECG Blog

JANUARY 21, 2023

The relationship between J wave and ventricular tachycardia during Takotsubo cardiomyopathy. Prominent J waves and ventricular fibrillation caused by myocarditis and pericarditis after BNT162b2 mRNA COVID-19 vaccination. Can J Cardiol 2022 Kukla P, Jastrezebski M, Praefort W.

STEMI 52

STEMI Bradycardia Arrhythmia Cardiac Arrest 52

Dr. Smith's ECG Blog

MARCH 8, 2025

2:34 PM, following right heart catheterization She then went into atrial fibrillation with complete heart block and junctional escape rhythm prompting placement of transvenous pacemaker. Defibrillation strategies for refractory ventricular fibrillation. Case discussion: This is a tragic case. link] Bai, J., Tang, Z., &

Cardiomyopathy 74

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia 74