Dr. Smith's ECG Blog

OCTOBER 23, 2023

She was successfully revived after several rounds of ACLS including defibrillation and amiodarone. 2022 Jul;27(4):e12939. Epub 2022 Feb 11. I last reviewed the phenomenon of electrical alternans in My Comment at the bottom of the page in the November 28, 2022 post of Dr. Smith's ECG Blog. Ann Noninvasive Electrocardiol.

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Tachycardia Cardiac Arrest ICU Blog 130

Journal of the American Heart Association

FEBRUARY 8, 2025

We hypothesized an interaction effect and conducted stratified analyses to investigate whether witnessed arrest is more important than bystander CPR.MethodsThis study enrolled patients with outofhospital cardiac arrest between January 2010 and December 2022 in 3 emergency medical service (systems in Taiwan).

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Cardiac Arrest Hospital Defibrillator Outcomes 45

Dr. Smith's ECG Blog

OCTOBER 21, 2022

Searching for regular QRS complexes marching through potential artifact can help distinguish artifactual vs. actual ECG rhythms. == MY Comment, by K EN G RAUER, MD ( 10/19 /2022 ): == Today’s case by Dr. Meyers ( submitted by Dr. Arjun JV ) — is important for recognizing what it is not. This is not VFib or polymorphic VT!

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Tachycardia Atrial Fibrillation Defibrillator Blog 52

Dr. Smith's ECG Blog

SEPTEMBER 29, 2024

Today's case reminds us of the intuitive logic that if a patient has a shockable arrest ( ie, VFib ) — and following successful defibrillation shows evidence of acute OMI ( even if STEMI criteria are not necessarily fulfilled ) — that such patients have much to gain from immediate cath with PCI. ( The April 8, 2022 post by Drs.

Cardiac Arrest 109

Cardiac Arrest STEMI Ischemia SCAD 109

Journal of Cardiovascular Electrophysiology

FEBRUARY 15, 2024

Methods Patients undergoing CIED surgery for approved indications between June 2015 and June 2022 were identified. The top two indications for the procedure included CIED generator change ( n  = 9, 41%) and implantable cardioverter-defibrillator (ICD) implantation ( n  = 7, 32%). The mean age was 50.2 ± 18.2

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Defibrillator Electrophysiology Outcomes Article 40

EMS 12-Lead

AUGUST 22, 2022

We can, therefore, put down the defibrillation pads, set aside the amiodarone, and look further at the ECG. Paradoxically, though, the third green arrow identifies a QRS that is more narrow than the RBBB complexes surrounding it. Question 2: What explains the conduction abnormalities? Indian Pacing and Electrophysiology Journal, 6(3), 182-83.

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Tachycardia Electrophysiology Cardiomyopathy ICU 52

Dr. Smith's ECG Blog

JANUARY 23, 2023

When the ICD was finally interrogated, the syncopal events and shocks correlated with two VF events that were defibrillated successfully. The vessel was likely patent or nearly patent at the time of this ECG.

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Chest Pain Blog Stenosis Myocardial Infarction 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

She was defibrillated and resuscitated. J Electrocardiol [Internet] 2022;Available from: [link] Cardiology opinion: Takotsubo Cardiomyopathy (EF 30-35%) V Fib Cardiac arrest Prolonged QTC NSTEMI (Smith comment: is it NSTEMI or is it Takotsubo? -- these are entirely different) Moderate single-vessel CAD.

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Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

MARCH 15, 2023

We examined the effect of ibutilide, a class III antiarrhythmic agent, on the energy requirement for atrial defibrillation and assessed the value of this agent in facilitating cardioversion in patients with atrial fibrillation that is resistant to conventional transthoracic cardioversion. 25, 2022 ).

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Atrial Fibrillation AFIB Arrhythmia Exercise 52

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. These devices offer a non-invasive and temporary solution, providing continuous monitoring and the potential for prompt defibrillation when needed. years, with 78% being male.

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Defibrillator Sudden Cardiac Death Arrhythmia Outpatient 52

Ken Grauer, MD

JUNE 27, 2024

As reviewed by Almarzuqi et al ( Vasc Health Risk Mgmt 18:397-406, 2022 ) — Potential Causes of Bidirectional VT include: Digitalis toxicity. Despite prolonged resuscitation with multiple defibrillation attempts — the patient could not be saved. = CPVT ( Catecholaminergic PolyMorphic VT ). Acute myocardial ischemia.

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Blog Cardiac Arrest Sudden Cardiac Death Tachycardia 160

EMS 12-Lead

MARCH 30, 2024

As this case shows, electrical capture isn't always possible at lower currents, especially with pads placed in a standard anterolateral "defibrillation" position. The University of Maryland found that capture occurred in only 42-78% of patients, dependent on pad positioning (Moayedi et al, 2022).

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Cardiac Arrest Pacemaker Pulmonary Bradycardia 124

Dr. Smith's ECG Blog

JULY 21, 2024

He required multiple defibrillations within a period of a few hours. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation. Some episodes of PMVT would terminate spontaneously — but on many occasions, the PMVT degenerated to VFib, requiring defibrillation.

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Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Circulation

NOVEMBER 11, 2024

003) and 2022 ESC risk model (log-likelihood ratios, -268.4 In the subgroup with Class 3 of recommendation for implantable cardioverter defibrillator, patients with absolute LV-GLS ≤ 9% showed significantly worse prognosis than those with absolute LV-GLS > 9% (p =.002 vs -266.2; vs -264.9; 009), respectively.

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Cardiomyopathy Sudden Cardiac Death Defibrillator Risk Factors 40

Dr. S. Venkatesan MD

FEBRUARY 20, 2024

Tackling SCD was in God’s domain, until the brilliance of Dr. Michel Mirowski shrunk the defibrillator and implanted it under the chest in 1980. (Dr. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure.

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Defibrillator Heart Failure Sudden Cardiac Death Cardiomyopathy 52

Cardiomatics

FEBRUARY 9, 2022

Both the Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure (COMPANION) and the Cardiac Resynchronisation—Heart Failure (CARE-HF) trials [3,4], which were the cornerstone of electrotherapy in HF patients, showed up to a 36% reduction in mortality, an effect size rarely seen in trials today [5]. 2022, 9, 17.

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Heart Failure Myocardial Infarction Medicare Defibrillator 52

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

This episode self terminated before defibrillation was possible. This run of TdP is initiated by a PVC — but it then self-terminates. ECG #3 Interpretation of ECG #3: This rhythm begins as Torsades de Pointes — that then becomes V-Fib. Discussion : The patient in today’s case presented with "seizures".

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Tachycardia Blog Sudden Cardiac Death Arrhythmia 113

Dr. Smith's ECG Blog

JUNE 14, 2024

But artifact is "alive and well" — and learning to recognize it will amaze many of your colleagues ( and may serve to avoid an unnecessary defibrillation or two ). The October 21, 2022 post — for " artifactual VT". Like most clinicians — I learned about artifact "the hard way" = by seeing clinical cases that initially fooled me.

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Atrial Fibrillation Tachycardia Blog Chest Pain 81

All About Cardiovascular System and Disorders

OCTOBER 25, 2023

CASTLE-AF randomized 363 patients with atrial fibrillation and left ventricular ejection fraction of 35% or less, NYHA class II-IV heart failure and having an implanted defibrillator to either catheter ablation or medical therapy with rate or rhythm control [5]. 2022 Nov 22;146(21):1561-1563. Epub 2022 Nov 21. N Engl J Med.

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Atrial Fibrillation Heart Failure Ablation Cardiac Arrest 52

Frontiers in Cardiovascular Medicine

DECEMBER 13, 2023

Primary preventive therapies, such as implantable cardioverter defibrillators, are not personalized and not predictive. All included ACP patients were recruited in 2009 at Yonsei University Hospital and were followed up until 2022. Most of these devices do not deliver life-saving therapy during their lifetime. years), 11 patients died.

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Chest Pain Cardiac Arrest Public Health Defibrillator 64

Journal of Cardiovascular Electrophysiology

FEBRUARY 13, 2024

Methods Between September 2001 and June 2022, all consecutive patients with diagnosis of BrS were enrolled in the present study. Fifteen percent received appropriate implantable cardioverter-defibrillator (ICD) therapy and inappropriate ICD interventions were observed in 17%. 95% confidence interval: 0.7–19.6,

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Electrocardiogram Defibrillator Ischemia Heart Disease 40

Dr. Smith's ECG Blog

JANUARY 15, 2024

Rhythm C: This telemetry strip from an older adult was initially thought to need defibrillation. The October 21, 2022 post — for " artifactual VT". Rhythm B: This patient was seen in the ED — and thought to be in AFlutter with 4:1 AV conduction. The March 17, 2023 post — for PTA. The January 17, 2023 post — for PTA.

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Chest Pain Blog Arrhythmia Critical Care 64

Dr. Smith's ECG Blog

OCTOBER 10, 2022

It was reportedly a PEA arrest; there was no recorded V Fib and no defibrillation. 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”!

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Cardiac Arrest Chest Pain Embolism Pulmonary 52

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

The patient was put on Extracorporeal Life Support in the ED 3 hours after initial resuscitation, the core temp was 30° C and the patient was defibrillated with a single attempt. On arrival, CPR was continued and core temperature was measured at 18° C (64.4° A 12-lead ECG was recorded: There is sinus rhythm with RBBB and right axis deviation.

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Cardiac Arrest Bradycardia Chest Pain Ischemia 40

DAIC

JANUARY 30, 2024

5] Immediate CPR and defibrillation are key to doubling the survival rate of cardiac arrest by 2030. 387 (2022): 1569-1578. In a 2023 consumer survey, over half of the participants said they would perform either CPR or Hands-Only CPR and that their confidence level in performing CPR has improved from 2021. [5] Circulation 147, no.

Cardiac Arrest 102

Cardiac Arrest Defibrillator Hospital Outcomes 102

Journal of Cardiovascular Electrophysiology

NOVEMBER 10, 2024

ABSTRACT Introduction The subcutaneous implantable cardioverter defibrillator (S-ICD) is an alternative to a transvenous ICD in patients who meet the criteria for ICD implantation without concurrent need for cardiac pacing. The objective of this study is to examine the rates of and indications for S-ICD removal and extraction.

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Bradycardia Defibrillator Article 40

Dr. Smith's ECG Blog

MARCH 25, 2025

In this case, you should get a second defibrillator and perform double sequential external defibrillation (DSED). Simply attach a second defibrillator as shown in the diagram below and deliver max shocks from both devices simultaneously. In the second case, the patient never converted meaning the shock did not do its job at all.

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Chest Pain Ischemia Plaque Stents 63

Dr. Smith's ECG Blog

DECEMBER 27, 2024

The submitter started the patient on amiodarone and arranged implantation of a defibrillator. == MY Comment , by K EN G RAUER, MD ( 12/27 /2024 ): == Superb discussion by Dr. Frick in today's case, that highlights a series of important points regarding the ECG recognition of stable VT ( V entricular T achycardia ).

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Tachycardia Stents Stent Arrhythmia 121

European Journal of Heart Failure

DECEMBER 1, 2024

The primary endpoint was survival at 180 days and freedom from implantable cardioverter-defibrillator (ICD), heart transplant/left ventricular assist device (LVAD), or readmission for heart failure. Between June 2022 and April 2024, 20 patients with CS (64 ± 8.9 years,

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Cardiogenic Shock Heart Transplant Outcomes Transplant 40

Dr. Smith's ECG Blog

MARCH 8, 2025

Several 200 J shocks did not terminate the VF, so a second defibrillator was applied for double sequential defibrillation with 400 J. She was defibrillated perhaps 25 times. Propranolol versus Metoprolol for treatment of electrical storm in patients with implantable cardioverter-defibrillator. SanzRuiz, R., Solis, J., &

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Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia 75

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

Most patients can be managed without and implantable cardioverter defibrillator (ICD) In patients with PVCs/VT and a presentation not typical for an idiopathic origin cardiac magnetic resonance (CMR) should be considered, even if the Echo is normal. 2022, September 2) [2] Ward, R. Van Zyl, M., & & DeSimone, C. 3] Lavalle, C.

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Tachycardia Arrhythmia Ablation Atrial Flutter 72