Dr. Smith's ECG Blog

MARCH 7, 2024

There were times when it would be usurped by sinus tachycardia, then return to this rhythm. There is no atrial activity to suggest atrial fibrillation. This does NOT seem irregularly irregular enough for AFib … Instead — there is almost “group beating” with “Wenckebach periodicity”. There is a wide complex.

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Hemorrhage Chest Pain AFIB Article 124

Dr. Smith's ECG Blog

JULY 5, 2024

There is a regular wide complex tachycardia. Remember : Adenosine is safe in Regular Wide Complex Tachycardia. Adenosine is only unsafe in atrial fibrillation with WPW , which presents with a very rapid rate, polymorphic QRS, and some very short RR intervals] Bedside echo showed poor LV fct. We want to avoid a stroke.

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Atrial Flutter Tachycardia Atrial Fibrillation AFIB 112

Dr. Smith's ECG Blog

AUGUST 13, 2020

His previous echo one month prior shows the same thing: “consistent with old infarct in LAD vascular territory, with EF 45%” "I think there is something else causing his tachycardia which is exaggerating his EKG findings and mimicking an acute myocardial infarction." Looks like atrial fibrillation. Cath lab was cancelled.

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Tachycardia AFIB Cardiogenic Shock Myocardial Infarction 52

Dr. Smith's ECG Blog

DECEMBER 16, 2018

Wide-complex tachycardia: VT or aberrant, or "other?" The patient had a history of paroxysmal atrial fibrillation and several cardioversions. A wide-complex tachycardia in an older patient must immediately suggest ventricular tachycardia. And indeed the QRS morphology strongly supported VT (e.g. Note of Caution!

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Tachycardia Atrial Flutter AFIB Atrial Fibrillation 52

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

This strip was obtained: Apparent Wide Complex Tachycardia at a rate of 280 What do you think? Recently diagnosed with intermittent paroxysmal atrial fibrillation but no EKGs available to confirm. Troponins 34>33>43, likely secondary to myocardial injury from tachycardia. Sinus tachycardia does not go this fast.

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Atrial Flutter Exercise AFIB Tachycardia 63

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. Atrial fibrillation is also a predictor of worse outcomes in this case (Alborzi). Sinus Tachycardia ( common in any trauma patient. ). He was intubated for altered mental status.

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Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia 114

Dr. Smith's ECG Blog

MARCH 11, 2020

Therefore — the rhythm in ECG #1 is almost certain to be AFib ( A trial F ibrillation ) , seen here with a “rapid” ventricular response. Under normal conditions with AFib — the refractory period of the AV node does not allow more than 150-to-200 impulses/minute to be conducted to the ventricles.

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AFIB Tachycardia Atrial Fibrillation Arrhythmia 52

Dr. Smith's ECG Blog

DECEMBER 23, 2019

Initial ECG in the ED: Presenting ECG : Wide-complex tachycardia at a rate about 200. This is overwhelmingly likely to be ventricular tachycardia, even if only age and medical history are considered. Nevertheless, the widths of both the QRS complex and the RS duration are similar in both the old ECG and the tachycardia.

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Tachycardia Atrial Flutter Cardiomyopathy Atrial Fibrillation 52

Cardiomatics

APRIL 5, 2024

Sinus tachycardia – sinus rhythm above 100 bpm is a sinus tachycardia. Ventricular tachycardia – more than 7 consecutive complexes originating from ventricles at a rate of > 100 bpm. Supraventricular tachycardia – more than 7 consecutive complexes of supraventricular beats at a rate of > 100 bpm.

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Arrhythmia Tachycardia Bradycardia Electrocardiogram 92

AMS Cardiology

JANUARY 16, 2024

Continue reading to learn more about this procedure, its significance in treating atrial fibrillation, and what to expect during treatment. What is Atrial Fibrillation? Before diving into electrical cardioversion, we should understand atrial fibrillation (AF). What Is Cardioversion?

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Atrial Fibrillation Heart Rhythm AFIB Atrial Flutter 52

Circulation

NOVEMBER 11, 2024

The presence or absence of five predetermined cardiac arrhythmias were evaluated: atrial fibrillation/flutter (AFIB), ventricular bigeminy, ventricular trigeminy, ventricular tachycardia (VT), and high-grade atrioventricular block (AVB).Results:The For AFIB, the sensitivity was 0.76 and 0.94, respectively.

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AFIB Arrhythmia Atrial Fibrillation Tachycardia 40

Dr. Smith's ECG Blog

AUGUST 17, 2022

ACUTE MI (I allowed Acute MI to be in the report because I knew there would be an elevated troponin from ischemia, which is the definition of acute MI -- but in this case it would most likely be a Type 2 MI from tachycardia) There is also LA-RA lead reversal. The rhythm is rapid AFib. She had some fractures.

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Atrial Fibrillation Ischemia AFIB Tachycardia 52

Dr. Smith's ECG Blog

APRIL 24, 2022

The ECG there reportedly showed an irregular tachycardia, and the patient was immediately referred to the emergency room. Here is her ECG on arrival: There is a wide complex tachycardia that is irregularly irregular (this is difficult to determine at these very high rates). Lead aVR seems to show the atrial activity clearly.

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AFIB Tachycardia Atrial Fibrillation Blog 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

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 atrial fibrillation. Note: The patient while on telemetry had alternating atrial fibrillation, sinus rhythm with 1st degree AV block and also periods of Wenckebach conduction.

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Cardiac Arrest Cardiomyopathy Arrhythmia Atrial Fibrillation 67

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Case submitted and written by Mazen El-Baba MD, with edits from Jesse McLaren and edits/comments by Smith and Grauer A 90-year old with a past medical history of atrial fibrillation, type-2 diabetes, hypertension, dyslipidemia, presented with acute onset chest/epigastric pain, nausea, and vomiting. The patient was placed on telemetry.

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Ischemia STEMI Stenosis Chest Pain 52

DAIC

JULY 24, 2024

The collaboration, according to a written statement issued by the company, aims to address challenges in capturing and analyzing cardiac signals to help physicians enhance patient outcomes for atrial fibrillation procedures. 1 Approximately 33 million patients worldwide are living with AFib.

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Atrial Fibrillation AFIB Ablation Technology 105

AMS Cardiology

NOVEMBER 21, 2024

space-line Alcohol and ‘Holiday Heart Syndrome’ Holiday heart syndrome refers to episodes of supraventricular tachycardia: a sudden arrhythmia or irregularity in which the heart beats much faster than normal, explains Dr. Schuitema. Alcohol acts as a natural irritant to the heart muscle, says Dr. Tarditi.

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Heart attacks Heart Attack Heart Failure Blood Pressure 52

Dr. Smith's ECG Blog

JUNE 14, 2024

The team immediately paged cardiology, concerned for polymorphic ventricular tachycardia. Since sinus conducted QRS complexes cannot co-exist together with ventricular tachycardia, this must all be artifact. Such as atrial fibrillation or sinus rhythm with extrasystoles. Telemetry Sample 2 Does this change how you feel?

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Atrial Fibrillation Tachycardia Blog Chest Pain 81

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

Chart review confirmed that he had been started on flecainide for atrial fibrillation. This new information makes the diagnosis of atrial flutter far more likely: first, atrial fibrillation and flutter are closely associated and, second, this makes a flutter rate of 200 bpm (with 1:1 conduction) quite likely.

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Ischemia Atrial Flutter Arrhythmia Tachycardia 52

Dr. Smith's ECG Blog

MARCH 6, 2020

Here was his ED ECG: There is sinus tachycardia (rate about 114) with nonspecific ST-T abnormalities. There is a large peaked P-wave in lead II (right atrial enlargement) There is left axis deviation consistent with left anterior fascicular block. See my quick review of atrial tachycardia below) The tachycardia spontaneously resolved.

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Heart Failure Tachycardia Atrial Flutter Cardiomyopathy 52

Dr. Smith's ECG Blog

OCTOBER 10, 2022

The rhythm is atrial fibrillation. I sent it to 2 of my ECG nerd colleagues with no clinical information whatsoever, who instantly said: "Looks like afib with subendocardial ischemia and right heart strain pattern." "I Tachycardia is of course, quite common in patients following cardiac arrest. The rhythm is rapid AFib.

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Cardiac Arrest Chest Pain Embolism Pulmonary 52

Dr. Smith's ECG Blog

NOVEMBER 24, 2017

Answer : you must treat the patient's underlying condition causing sinus tachycardia, and repeat the ECG at the lower heart rate. Rate correction should not be used when RR interval has large variability, as in atrial fibrillation. Correlation of QT Interval Correction Methods During Atrial Fibrillation and Sinus Rhythm.

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Bradycardia Article Atrial Fibrillation Chest Pain 52

Dr. Smith's ECG Blog

JANUARY 26, 2025

Figure-1: While at first glance the rhythm in Figure-1 might be mistaken for sinus tachycardia in fact, this is not the rhythm. Instead there is 2:1 atrial activity that is best seen in lead V1 ( See Figure-2 ). The AFib had been well controlled on Flecainide for many years. Figure-1: The initial ECG in today's case.

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Atrial Flutter Tachycardia AFIB Hospital 65