Dr. Smith's ECG Blog

SEPTEMBER 3, 2010

One might think this represents acute STEMI, or Bundle branch block with discordant ST segments and suspicously concordant T-waves. Ablation was planned for a later date. Upon arrival to the ED, he had the following 12-lead ECG: There is striking ST segment elevation in V1 and V2, with ST depression in V3-V6 as well as I, II, and aVF.

Tachycardia 52

Tachycardia Atrial Fibrillation STEMI Ablation 52

Dr. Smith's ECG Blog

JULY 21, 2024

The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion. In such cases — radiofrequency ablation of ectopic beats triggering malignant ventricular arrhythmias was needed for control of arrhythmic storm because the antiarrhythmic medications tried were ineffective ( Marrouche et al — JACC 5;43(9): 1715-20, 2004 ).

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

MAY 27, 2012

In other words, after reperfusion therapy for STEMI, the appearance of AIVR is usually a good sign, meaning that the artery is reperfused. 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.

Chest Pain 52

Chest Pain Ischemia Dysrhythmia STEMI 52

Dr. Smith's ECG Blog

MAY 10, 2023

A 34 yo woman with a history of HTN, h/o SVT s/p ablation 2006, and 5 months post-partum presented with intermittent central chest pain and SOB. Thus, Wellens' syndrome should be thought of as a transient OMI or transient STEMI. Transient STEMI is at high risk of re-occlusion. This was sent by a colleague.

Coronary Angiogram 52

Coronary Angiogram Chest Pain Stenosis STEMI 52

Dr. Smith's ECG Blog

OCTOBER 13, 2022

But it doesn’t meet STEMI criteria, and was not identified by the computer or the over-reading cardiologist. Still no WPW pattern, and more obvious inferoposterior OMI, but still STEMI negative. The emergency physician wasn’t sure what to make of the changes from one ECG to the next but was concerned about ACS. What do you think?

Chest Pain 52

Chest Pain Myocardial Infarction Ischemia STEMI 52

Dr. S. Venkatesan MD

AUGUST 19, 2024

There is a problem here too ,even critical Ischemia with high grade unstable angina rarely trigger a VT but STEMI seems to have the exclusive rights to trigger it , by its ability to produce acute transmural ischemia. best , it is just a back up device to tackle the escaped VTs in spite of RF ablation and drugs. Reference 1.

Ischemia 52

Ischemia Sudden Cardiac Death Ablation Arrhythmia 52