Dr. Smith's ECG Blog

OCTOBER 24, 2024

Especially when present in the setting of bradycardia and syncopal episodes, this is very worrisome for high risk of lethal dysrhythmias including polymorphic ventricular fibrillation (termed Torsades when in the setting of long QT). This ECG shows sinus bradycardia with massively long QT (or QU?) interval, at over 600 msec.

Dysrhythmia 110

Dysrhythmia Atrial Fibrillation Bradycardia Ablation 110

Dr. Smith's ECG Blog

JUNE 11, 2023

An accessory pathway was identified and was ablated. The patient has not had any recurrent episodes of atrial fibrillation and has a narrow QRS complex without delta wave on his ECG post ablation. Post ablation: This patient had a similar visit 4 years previously: The patient had a prior admission 4 years ago for the same presentation.

Tachycardia 98

Tachycardia Atrial Fibrillation Chest Pain Blood Pressure 98

Dr. Smith's ECG Blog

MAY 27, 2012

Our electrophysiologist, Rehan Karim, states he has ablated AVNR"T" ("T" because it is not tachycardia) in a 90 year old, and that he has seen rate-related BBB at very slow rates. The second explanation (AIVR), whether as a reperfusion dysrhythmia or not, seems most likely.

Chest Pain 52

Chest Pain Ischemia Dysrhythmia STEMI 52

Dr. Smith's ECG Blog

DECEMBER 24, 2023

Flecainide : This is a potentially dangerous Na channel blocker which can cause ventricular dysrhythmias including ventricular fibrillation. Is this patient a candidate for cardioversion or ablation? ( If ablation is contemplated — definitive diagnosis will be made at EP study. ( How to Distinguish Between AFlutter vs ATach?

Atrial Flutter 127

Atrial Flutter Blog Aortic Aortic valve 127

Dr. Smith's ECG Blog

OCTOBER 25, 2022

But adenosine only lasts for seconds, and if the dysrhythmia recurs, then the adenosine is gone. Prevent the initiation of the dysrhythmia -- this can be done with a beta blocker by prenenting PACS 2. There is no need to immediately refer today’s patient to EP for ablation. Smith: should we give adenosine again?

Tachycardia 52

Tachycardia Atrial Flutter Dysrhythmia Ablation 52

Dr. Smith's ECG Blog

SEPTEMBER 7, 2020

The patient was found to have a "concealed" posteroseptal pathway (WPW without delta waves) confirmed to have SVT at EP study and was ablated. Here is the Electrophysilogist's note: "Only 1 pathway attachment could be ablated, the second one deep within the CS could not be ablated with high power.

Tachycardia 52

Tachycardia Heart Disease Dysrhythmia Ablation 52