Dr. Smith's ECG Blog

MAY 7, 2024

Since the ventricular response in ECG #2 is comparable to the rate range for any patient who develops new-onset AFib — definitive diagnosis of WPW was not made in today's case until the 3rd ECG was obtained. FINAL Points in Today's CASE: Even though the SPERRI value during AFib in today's case was not below 250 msec.

Atrial Fibrillation 130

Atrial Fibrillation AFIB Ablation Chest Pain 130

Ken Grauer, MD

MAY 31, 2024

The September 15, 2023 post — for PTA. The April 6, 2023 post — excessive baseline artifact misdiagnosed as AFib ( instead of sinus rhythm with AV Wenckebach — as in Figure-4 in this post ). The March 17, 2023 post — for PTA. The January 17, 2023 post — for PTA. The October 21, 2022 post — for " artifactual VT".

Blog 164

Blog AFIB Defibrillator Article 164

DAIC

MARCH 28, 2024

"Based on the results from the admIRE clinical trial, we are confident that this innovation has the promise to deliver significant value and differentiated capabilities, and become an important tool for the treatment of AFib." 2,3 Approximately 1 in 4 adults over the age of 40 are at risk for developing AFib. In the U.S.,

Atrial Fibrillation 110

Atrial Fibrillation AFIB Ablation Pulmonary 110

DAIC

JUNE 19, 2024

While the spotlight in 2023 shone on developments around Generative Artificial Intelligence (AI), away from the limelight a quiet revolution in AI was taking place, which promises to transform the way we diagnose, manage, and treat cardiovascular diseases, the world’s leading cause of death.

AFIB 105

AFIB Reimbursement Research Atrial Fibrillation 105

Dr. Smith's ECG Blog

DECEMBER 13, 2024

KEY Point: Nothing other than AFib with WPW results in a ventricular response this fast ( which is why Figure-2 is pathognomonic for AFib in a patient with WPW ). Regarding AFib with WPW: The very rapid heart rate and at times extremely short R-R intervals put the patient with AFib and WPW at risk of cardiac arrest from VFib.

AFIB 103

AFIB Atrial Fibrillation Tachycardia Blog 103

DAIC

FEBRUARY 2, 2024

The results support the use of workflows to reduce radiation exposure during catheter ablation for the treatment of paroxysmal atrial fibrillation (AFib) while maintaining safety, efficacy, and long-term patient outcomes comparable to traditional procedures.1 1 These included one pseudoaneurysm, one PV stenosis and one hematoma.1

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Ablation Atrial Fibrillation AFIB Heart Rhythm 105

Dr. Smith's ECG Blog

AUGUST 18, 2024

We've periodically reviewed cases regarding Pacemaker Troubleshooting ( See the February 18, 2024 post — the January 13, 2024 post — the October 19, 2022 post — the August 3, 2022 post — the May 21, 2023 post — the June 19, 2024 post — and the November 9, 2018 post , to name a number of them ).

Pacemaker 110

Pacemaker AFIB Atrial Fibrillation 110

DAIC

FEBRUARY 27, 2024

Atrial fibrillation ( AFib ) affects approximately 38 million patients globally, significantly increasing the risk of stroke1,2. The This is particularly important for the nearly 40% of AFib patients who cannot tolerate long-term blood thinners3,4.  The acquisition of Laminar, Inc.

Atrial Fibrillation 105

Atrial Fibrillation Innovation AFIB Pharmacology 105

DAIC

DECEMBER 22, 2023

SmartPulse is a prospective, single arm, multi-center, clinical evaluation that will enroll approximately 250 patients with paroxysmal AFib in the United States to evaluate the safety and effectiveness of the Dual Energy STSF Catheter. “ The SmartPulse pivotal trial will allow us to learn more about the promise of PFA in paroxysmal AFib.

Atrial Fibrillation 59

Atrial Fibrillation AFIB Ablation Heart Rhythm 59

DAIC

APRIL 3, 2024

The Low EF AI will be added to Eko’s SENSORA Cardiac Early Detection Platform , the latest advancement to the platform which already features FDA-cleared algorithms to identify AFib and structural heart murmurs, often an indicator of valvular heart disease. 2023, January 5). 2023, November 13). sensitivity, and 79.4%

Heart Failure 111

Heart Failure Cardiomyopathy AFIB Hospital 111

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

The rhythm is irregularly irregular, and appears to be AFib with a fairly slow ventricular response ( overall rate <70/minute ) — although marked baseline artifact renders the search for atrial activity futile. Baseline artifact is no longer present.

Blog 137

Blog Cardiac Arrest Atrial Fibrillation Bradycardia 137

Ken Grauer, MD

FEBRUARY 18, 2023

These findings suggest that instead of VT — the rhythm in Figure-1 is AFib with a fairly rapid ventricular response. Since the rhythm is supraventricular (ie, AFib ) — we can accurately assess QRS morphology. Given a lack of prior history — I don’t know if the AFib on ECG #1 is ( or is not ) a new finding.

Blog 78

Blog AFIB Chest Pain STEMI 78

DAIC

DECEMBER 8, 2023

Getty Images milla1cf Fri, 12/08/2023 - 08:17 December 8, 2023 — The American College of Cardiology (ACC) and the American Heart Association (AHA), along with several other leading medical associations, have issued a new guideline for preventing and optimally managing atrial fibrillation (AFib).

Atrial Fibrillation 52

Atrial Fibrillation AFIB Strokes Stroke 52

American College of Cardiology

DECEMBER 2, 2024

Food and Drug Administration (FDA) approval in December 2023, it opened up the proverbial Pandora's Box for treating not only atrial fibrillation (AFib), but also ventricular arrhythmias. When pulsed field ablation (PFA) achieved European CE mark approval in January 2021 and U.

Arrhythmia 40

Arrhythmia Ablation Atrial Fibrillation AFIB 40

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

Is longterm endurance-training a risk factor for AFib and AFlutter? == Why is Today's Initial Rhythm AFlutter? Smith's ECG Blog — quick determination of heart rate often provides an important clue to the etiology of certain regular SVT ( S upra V entricular T achycardia ) rhythms ( See My Comment in the July 19, 2023 post , among others ).

Atrial Flutter 64

Atrial Flutter Exercise AFIB Tachycardia 64

Dr. Smith's ECG Blog

MARCH 15, 2023

My Comment by K EN G RAUER, MD ( 3/15 /2023 ): = I found today’s case highly instructive in highlighting a number of important aspects regarding the presentation and initial treatment of a patient who presents to the ED with new AFib. I focus my comment on a few additional aspects regarding new AFib.

Atrial Fibrillation 52

Atrial Fibrillation AFIB Arrhythmia Exercise 52

Ken Grauer, MD

MARCH 29, 2023

M y I MPRESSION : The rhythm in Figure -1 is almost certain to be very rapid AFib in a patient with WPW. NOTE #2: Surprisingly, it is not uncommon for patients in AFib with WPW to be hemodynamically stable — despite having exceedingly rapid ventricular rates. ECG Blog #284 — Reviews a case similar to today's Very Fast AFib.

Blog 78

Blog AFIB Arrhythmia Download 78

Ken Grauer, MD

JANUARY 13, 2024

A bout H CM ( Different Forms of this Entity ): I've excerpted what appears below from My Comment in the December 26, 2023 post in Dr. Smith's ECG Blog. WPW Cardiac arrhythmias ( including AFib ). Tall R wave in lead V1 and/or early transition in the chest leads ( reflecting increased "septal" forces ).

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Blog Ischemia AFIB Hypertension 159

Dr. Smith's ECG Blog

JUNE 14, 2024

The September 15, 2023 post — for PTA ( Pulse-Tap Artifact ). The April 6, 2023 post — excessive baseline artifact misdiagnosed as AFib ( instead of sinus rhythm with AV Wenckebach — as in Figure-4 in this post ). The March 17, 2023 post — for PTA. The January 17, 2023 post — for PTA.

Atrial Fibrillation 81

Atrial Fibrillation Tachycardia Blog Chest Pain 81

Ken Grauer, MD

FEBRUARY 28, 2023

As a result, in order to differentiate MAT from the much more commonly encountered irregularly irregular rhythm ( which is AFib ) — we need to be certain we are seeing multiple different P wave morphologies that are constantly changing. Clinically , the importance of recognizing MAT — is that treatment is different than the treatment of AFib.

Blog 78

Blog COVID-19 AFIB Pulmonary 78

Dr. Smith's ECG Blog

FEBRUARY 18, 2024

The September 15, 2023 post — for PTA ( Pulse-Tap Artifact ). The April 6, 2023 post — excessive baseline artifact misdiagnosed as AFib ( instead of sinus rhythm with AV Wenckebach — as in Figure-4 in this post ). The March 17, 2023 post — for PTA. The January 17, 2023 post — for PTA.

Pacemaker 109

Pacemaker Blog Atrial Fibrillation Electrophysiology 109

Heart 2023 Conference

APRIL 20, 2022

(Harvard University Heart Letter) A clinical polygenic risk score test for diseases ranging from atrial fibrillation (AFib) to breast cancer was piloted by scientists.

Pulmonary 52

Pulmonary Hypertension AFIB COVID-19 52

Dr. Smith's ECG Blog

DECEMBER 26, 2023

It was normal. == MY Comment , by K EN G RAUER, MD ( 12/26 /2023 ): == It's always rewarding to encounter an ECG that allows you to make an instant clinical pathophysiologic diagnosis. WPW Cardiac arrhythmias ( including AFib ). Tall R wave in lead V1 and/or early transition in the chest leads ( reflecting increased "septal" forces ).

Chest Pain 93

Chest Pain Cardiomyopathy Blog AFIB 93

Dr. Smith's ECG Blog

SEPTEMBER 24, 2023

Example: - A score of 0.6743 would be OMI Mid Confidence because it’s under the High confidence threshold (1-((1-0.1106)/3) = **0.70353**) and over the Low confidence threshold (**0.40706**) == MY Comment , by K EN G RAUER, MD ( 9/24 /2023 ): == I found today's case by Dr. Nossen interesting for a number of reasons.

Chest Pain 85

Chest Pain Atrial Fibrillation AFIB Myocardial Infarction 85

DAIC

MARCH 7, 2024

This integrated system leverages organized data like imaging report and waveform analysis reports in the cardiology care pathway and provide evidence based clinical decision support based on up to date AFib guidelines. Accessed September 28, 2023. Accessed September 25, 2023. Episode 1: The healthcare data explosion.

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Ultrasound Technology Innovation Hospital 103

CardiacWire

DECEMBER 3, 2023

dedicated LAA interventions), and has the unique ability to be recaptured, repositioned, and redeployed We usually have far earlier warning before Medtronic enters a completely new cardiac device segment, but that’s because it just acquired the Penditure system from medical device incubator Syntheon in August 2023.

AFIB 52

AFIB Innovation Ablation 52

Dr. Smith's ECG Blog

MAY 3, 2024

Despite the irregularity of QRS complexes — this rhythm is not AFib — because at least some definite P waves are present ( RED arrows that I added at the bottom of ECG #1 ). Smith has noted — recognition of Shark Fin morphology told us that the seemingly wide and irregular rhythm in Figure-1 was almost certain to be supraventricular!

Cardiogenic Shock 126

Cardiogenic Shock Cardiac Arrest Hospital Ischemia 126

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023. The patient’s inpatient course was complicated by new onset Afib with RVR and asymptomatic DVT with PE, however no etiology of coagulopathy was detected. A 6‐vessel cerebral angiogram as unremarkable.

Hemorrhage 40

Hemorrhage AFIB Cerebrovascular Disease Thrombosis 40

Dr. Smith's ECG Blog

MAY 26, 2023

Severely ill patients from any etiology can have very abnormal ECGs = My Comment by K EN G RAUER, MD ( 5/26 /2023 ): = There are more questions than answers in today's case. If the situation is not right for acute coronary occlusion, then the ECG findings probably do not represent acute coronary occlusion.

Cardiogenic Shock 98

Cardiogenic Shock Arrhythmia Blog Education 98

Dr. Smith's ECG Blog

JULY 7, 2023

MY Thoughts on Today's ECG: As per Dr. Smith — the rhythm in ECG #1 appears to be AFib with a controlled ventricular response ( ie, irregularly irregular without clear sign of P waves ). See further discussion of R/S ratio greater than 1 in lead V1 by Ken below. Figure-1: The initial ECG in today's case. ( What else?

Chest Pain 52

Chest Pain AFIB Blog Atrial Fibrillation 52

DAIC

DECEMBER 19, 2023

Image courtesy: Peerbridge Health christine.book Tue, 12/19/2023 - 10:22 December 19, 2023 — Peerbridge Health has announce the successful completion and findings of its prospective, feasibility clinical trial, resulting in a statistically significant 91.2%

Heart Failure 52

Heart Failure Innovation Heart Disease Quality of Life 52

Ken Grauer, MD

JULY 22, 2023

I see the following: Although there is no long lead rhythm strip — we can see that the rhythm is AFib with a controlled ventricular response ( ie, irregularly irregular rhythm without P waves — and with a heart rate between ~70-110/minute ). Regarding Intervals: There is no PR interval ( since the rhythm is AFib ).

Blog 78

Blog Chest Pain STEMI AFIB 78

Dr. Smith's ECG Blog

JANUARY 15, 2024

The September 15, 2023 post — for PTA ( Pulse-Tap Artifact ). The April 6, 2023 post — excessive baseline artifact misdiagnosed as AFib ( instead of sinus rhythm with AV Wenckebach — as in Figure-4 in this post ). The March 17, 2023 post — for PTA. The January 17, 2023 post — for PTA.

Chest Pain 64

Chest Pain Blog Arrhythmia Critical Care 64

Dr. Smith's ECG Blog

SEPTEMBER 12, 2023

Followup: he was found to have hyperparathyroidism == MY Comment , by K EN G RAUER, MD ( 9/12 /2023 ): == Today's ECG is remarkable for an uncommon but important finding that we periodically review, because it otherwise is all-too-easy to overlook. Thus, the patient's chemistry was done and revealed ionized hypercalcemia of 6.3

Cardiac Arrest 68

Cardiac Arrest Blog Atrial Fibrillation AFIB 68

Ken Grauer, MD

JULY 9, 2023

A cknowledgment : My appreciation to Chun-Hung Chen - 陳俊宏 ( from Taichung City, Taiwan ) for the case and this tracing. = == A DDENDUM ( 7/9/2023 ) — Additional material relevant to today's case: Figure-3: Summary of KEY points related to MAT. = ECG Blog #71 — Regarding the Ashman Phenomenon with AFib.

Blog 78

Blog Cardiac Arrest Pulmonary AFIB 78

Ken Grauer, MD

MARCH 12, 2023

Among the fast Supraventricular Rhythms: This is not AFib — because the rhythm is regular. A DDENDUM ( 3/13/2023 ) : I've presented this material before — but it bears repeating for reference. QRS morphology that almost certainly indicates a supraventricular etiology.

Blog 78

Blog Atrial Flutter Arrhythmia AFIB 78

Dr. Smith's ECG Blog

JANUARY 9, 2024

The patient also has a history of AFib and HFmrEF ( = H eart F ailure with M inimally- R educed E jection F raction ). the most commonly overlooked arrhythmia ( See My Comment at the bottom of the page in the May 1, 2023 — and the November 12, 2019 post , among others ).

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Tachycardia Electrophysiology Atrial Flutter Ischemia 119