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PMH: Known paroxysmal Atrial fib. He is usually is in sinus rhythm as far as he knows, but he cannot subjectively feel atrialfibrillation, so he is never completely certain when he is in sinus or atrial fib. Here is his ECG: Atrial Fib with a Ventricular Response of about 66. He immediately completely recovered.
Herein, we report results of a follow-up screening protocol for incident atrialfibrillation/flutter (AF) within a large observational digital health study. Of 59 participants who sent at least 1 EKG, 52 (88.1%) were in sinus rhythm, 3 (5.1%) AF, 2 (3.4%) indeterminate, and 2 (3.4%) sinus bradycardia.
Detection of Irregular Heart Rhythms Devices such as the Apple Watch or Fitbit Sense can detect irregular heart rhythms, including atrialfibrillation (AFib). These early warnings are critical, as AFib increases the risk of stroke and other heart-related complications.
Written by Pendell Meyers First try to interpret this ECG with no clinical context: The ECG shows an irregularly irregular rhythm, therefore almost certainly atrialfibrillation. After an initially narrow QRS, there is a very large abnormal extra wave at the end of the QRS complex. Is there a long QT? How would you manage this patient?
Her Apple Watch suddenly told her that she is in atrialfibrillation. Patients with healthy AV nodes who are not on AV nodal blockers and who are not hyperkalemic should have a rapid ventricular response if they have paroxysmal Atrialfibrillation. I focus my comment on a few additional aspects regarding new AFib.
This ECG shows sinus bradycardia with massively long QT (or QU?) 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). interval, at over 600 msec.
Sinus bradycardia – sinus rhythm below 60 bpm is a sinus bradycardia. AFIB/AFL – atrialfibrillation or atrial flutter episodes. Sinus tachycardia – sinus rhythm above 100 bpm is a sinus tachycardia. In healthy individuals occurs during exercising or strong emotions.
Atrialfibrillation is also a predictor of worse outcomes in this case (Alborzi). Other Arrhythmias ( PACs, PVCs, AFib, Bradycardia and AV conduction disorders — potentially lethal VT/VFib ). RBBB in blunt chest trauma seems to be indicative of several RV injury. Sinus Tachycardia ( common in any trauma patient. ).
She previously had Atrialfibrillation with LBBB. This shows atrialfibrillation. The fact that the response is regular proves that the atrialfibrillation is NOT conducting. When atrial fib conducts, the ventricular rate must always be irregular. There is a regular, slow response. Hyperkalemia.
Note: Due to the limited number of normally conducted beats — it is hard to be sure whether the underlying rhythm is sinus with baseline artefact or atrialfibrillation. Note: The patient while on telemetry had alternating atrialfibrillation, sinus rhythm with 1st degree AV block and also periods of Wenckebach conduction.
The patient had a history of paroxysmal atrialfibrillation and several cardioversions. Additionally, her beta-blocker dose had been decreased because of bradycardia, further predisposing her to atrial flutter. The underlying rhythm is AFib ( irregularly irregular QRS without P waves ).
Detail of Flutter waves The rate of the flutter waves matches the rate of the WCT (about 200/m), proving that the presenting WCT had been 1:1 atrial flutter. The subsequent EP study could not induce VT, only atrialfibrillation. Spontaneous 1:1 atrial flutter Atrial flutter usually has a rate of 300 F/m.
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