Dr. S. Venkatesan MD

APRIL 28, 2024

In all probability, this dilation is a form of atrial tachycardia and atrial cardiomyopathy. Spatial relationship of sites for atrial fibrillation drivers and atrial tachycardia in patients with both arrhythmias July 2017 International Journal of Cardiology 248(3) AF begets AF. Is there proof for this, or just an academic gossip?

Atrial Fibrillation 75

Atrial Fibrillation Bicuspid/Mitral Pulmonary Ablation 75

Dr. Smith's ECG Blog

SEPTEMBER 29, 2024

This usually represents posterior OMI, but in tachycardia and especially after cardiac arrest, this could simply be demand ischemia, residual subendocardial ischemia due to the low flow state of the cardiac arrest. This prompted cath lab activation. On arrival to the ED, this ECG was recorded: What do you think?

Cardiac Arrest 109

Cardiac Arrest STEMI Ischemia SCAD 109

EMS 12-Lead

MARCH 19, 2023

The shortened PR-interval, specifically, proved to be quite beguiling as it swept crews down a differential diagnosis of intermittent accessory pathway syndrome – insomuch as a “syndrome” of recurrent tachycardia to account for the patient’s symptoms. Thus, a high index of suspicion is paramount.

Myocardial Infarction 52

Myocardial Infarction STEMI Coronary Angiogram Coronary Artery Disease 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

That said — rhythm interpretation here is more of an academic interest — as the most striking findings are the widespread T-wave inversions and QT prolongation. But there are 3 other wide beats in the tachycardia that begins with beat #6 ( = beats #7; 13,14 ). The patient was diagnosed with stress cardiomyopathy.

Cardiac Arrest 67

Cardiac Arrest Cardiomyopathy Arrhythmia Atrial Fibrillation 67

Dr. Smith's ECG Blog

APRIL 29, 2020

A useful classification of WCT ( W ide- C omplex T achycardia ) rhythms — separates them into those that are mono morphic ( with similar QRS morphology during the tachycardia ) vs those that are poly morphic ( in which QRS morphology varies ). PEARL #2 — Distinction between PMVT vs Torsades is more than academic.

Cardiac Arrest 52

Cardiac Arrest Defibrillator Ischemia Tachycardia 52

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

I find AV dissociation in VT to be very difficult to differentiate from artifact, as there are always random blips on tachycardia tracings. Read this post: Idiopathic Ventricular Tachycardias for the EM Physician 2. Definitive diagnosis that ECG #1 is in fact VT is more than academic. Ken notes AV dissociation.

Tachycardia 138

Tachycardia Cardiogenic Shock Angina Coronary Angiogram 138

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

2) Tachycardia to this degree can cause ST segment changes in several ways. First , there can simply be diffuse ST depressions (which obligates reciprocal STE in aVR) associated with tachycardia which are not indicative of ischemia. Sometimes you must correct the rhythm to see what lies underneath. Is this inferor STEMI?

Ischemia 52

Ischemia Atrial Flutter Arrhythmia Tachycardia 52

Dr. Smith's ECG Blog

NOVEMBER 11, 2022

There is sinus tachycardia (do not be fooled into thinking this is VT or another wide complex tachycardia!) From an academic standpoint — I found several subtle ECG findings from the 2 tracings in this case to be especially interesting. She was alert and oriented and hypotensive with initial BP 70/50. Eur Heart J.

Chest Pain 52

Chest Pain Cardiogenic Shock Tachycardia Ischemia 52

Dr. Smith's ECG Blog

JULY 21, 2024

This progressed to electrical storm , with incessant PolyMorphic Ventricular Tachycardia ( PMVT ) and recurrent episodes of Ventricular Fibrillation ( VFib ). Distinction of PMVT vs VFib is an academic one in this case ). The patient improved, and on Day-11 of the hospital stay — he was off inotropes and on a small dose of a ß-blocker.

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

APRIL 8, 2015

If the patient has Abnormal Vital Signs (fever, hypotension, tachycardia, or tachypnea, or hypoxemia), then these are the primary issue to address, as there is ongoing pathology which must be identified. Academic Emergency Medicine., Academic Emergency Medicine, 2003 Volume 10, Number 5 539-540. Thiruganasambandamoorthy, V.,

Arrhythmia 52

Arrhythmia Outcomes Risk Factors Chest Pain 52

Dr. Smith's ECG Blog

APRIL 9, 2025

2025.110515 [link] Abstract Objective: The administration of amiodarone or lidocaine is recommended during the resuscitation of out-of-hospital cardiac arrest (OHCA) patients presenting with defibrillation-refractory or recurrent ventricular fibrillation or ventricular tachycardia. DOI: 10.1016/j.resuscitation.2025.110515

Defibrillator 63

Defibrillator Cardiac Arrest Myocardial Infarction STEMI 63