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Sinus bradycardia – sinus rhythm below 60 bpm is a sinus bradycardia. AFIB/AFL – atrial fibrillation or atrial flutter episodes. Other times, an irregular recording can signal a medical emergency, such as a myocardial infarction or a dangerous arrhythmia. Usually does not exceed 160 bpm.
Detection of Irregular Heart Rhythms Devices such as the Apple Watch or Fitbit Sense can detect irregular heart rhythms, including atrial fibrillation (AFib). These early warnings are critical, as AFib increases the risk of stroke and other heart-related complications.
Altered Mental Status, Bradycardia == MY Comment , by K EN G RAUER, MD ( 2/2 /2024 ): == Dr. Meyers began today’s case with the clinical challenge of asking you to identify the underlying cause of ECG #2. -- Read this ECG -- Osborn Waves and Hypothermia (this is the "Figure" above) What does LBBB look like in severe hypothermia?
Background The rising adoption of wearable technology increases the potential to identify arrhythmias. Those with arrhythmias or non-diagnostic EKGs were sent 7-day monitors. The EHR was reviewed after 3 years to determine if participants developed arrhythmias. Mean age was 50.5 (SD years, and 46 (53.3%) were female.
during which sinus bradycardia and arrhythmia are seen but not to a degree that produces symptoms. The easy way to remember the arrhythmias most commonly associated with SSS is to think of what one might expect if the SA node became sick. New slow AFib reflects a combination of these rhythm problems. second in duration.
Her vital signs were within normal limits except for bradycardia at 55 bpm. It is probably sinus bradycardia with very small/depressed P-waves and prolonged PR interval. P EARL # 4 In my opinion, it is not worth wasting time trying to figure out the specific rhythm diagnosis of a bradycardia when there is hyperkalemia.
. = 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.
Other Arrhythmias ( PACs, PVCs, AFib, Bradycardia and AV conduction disorders — potentially lethal VT/VFib ). NOTE: Prediction of cardiac contusion "severity" on the basis of cardiac arrhythmias and ECG findings — is an imperfect science. RBBB in blunt chest trauma seems to be indicative of several RV injury.
There are 3 etiologies I always think of with bradycardia and AV block: 1. C linical P oints R egarding E CG # 1 : We are told that the patient is a middle-aged woman and that she previously had been in AFib with LBBB. She could even have developed asystole. Hyperkalemia. Her K was normal 3. Ischemia. seconds in duration.
I focus my comments purely on a few sophisticated concepts in arrhythmia recognition — fully aware that specific rhythm disorders with calcium channel toxicity need not be treated per se, beyond providing cardiovascular support. It's always rewarding and mutually educational to discuss interesting aspects of arrhythmia interpretation.
Learning points : Takotsubo can lead to cardiac arrest from ventricular arrhythmia. Similar-looking wide beats #7,13,14 must also be aberrantly conducted supraventricular impulses — and since P waves are lost after beat #6 and subsequent R-R intervals are irregular — beats #7-thru-16 constitute a run of rapid AFib.
Additionally, her beta-blocker dose had been decreased because of bradycardia, further predisposing her to atrial flutter. During hospital admission she had a variety of atrial arrhythmias, which eventually resolved, likely due to her decreasing flecainide level. Note QRS widening for beats #14-thru-18 in ECG #3.
He has a family history concerning for arrhythmia. Given the circumstances of his car crash, we presume it was due to an underlying arrhythmia. He has a family history concerning for arrhythmia with his father requiring some sort of device (PPM, ICD, unclear) at a young age.
Instead — my thoughts were as follows: The rhythm is sinus , with marked bradycardia and a component of sinus arrhythmia. WPW Cardiac arrhythmias ( especially AFib ). Smith's — in that despite the alarming ST-T wave changes, I did not think ECG #1 was the result of an acute event. Abnormal ST-T wave abnormalities.
Although unfortunately there is no long lead II rhythm strip — RED arrows in ECG #2 highlight that sinus P waves ( the rhythm is sinus bradycardia and arrhythmia ) continue throughout the tracing , allowing us to establish with certainty the 7 sinus-conducted beats vs the 2 PVCs in this tracing. Only AFib was induced during EP study.
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