AFIB, Blog and Bradycardia - Cardiovascular Update

What is this ECG finding? Do you understand it before you hear the clinical context?

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

See our other blog posts of hypothermia and Osborn waves -- Massive Osborn Waves of Severe Hypothermia (23.6 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. Is there a long QT?

Blog

Blog Cardiac Arrest Atrial Fibrillation Bradycardia

How Wearable Tech Can Help Monitor Your Heart Health

MIBHS

JANUARY 31, 2025

This blog explores the ways wearable technology can help track heart health, the advantages it offers, and how it contributes to better outcomes for those requiring surgical intervention. These early warnings are critical, as AFib increases the risk of stroke and other heart-related complications.

Heart Rhythm

Heart Rhythm Technology AFIB Exercise

A woman in her 50s with dyspnea and bradycardia

Dr. Smith's ECG Blog

JANUARY 26, 2020

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.

Bradycardia

Bradycardia Ischemia Cardiac Arrest AFIB

A woman in her 70s with bradycardia and hypotension

Dr. Smith's ECG Blog

JANUARY 19, 2020

Resuscitation was initiated and this ECG was obtained: Likely AFib (irregularly irregular) with bradycardia. In addition to marked bradycardia — could there be high-grade AV block? STD in V2 from posterior MI can "pull down" the STE in V1 and negate it. Figure-2: ECG #2 — recorded on arrival in the ED ( See text ).

Bradycardia

Bradycardia STEMI AFIB Pacemaker

Syncope and Atrial fibrillation in a Healthy 70-something Male

Dr. Smith's ECG Blog

JULY 5, 2018

My Comment , by K EN G RAUER, MD ( 7/5/2018 ): This blog post provides an excellent example of how a patient with SSS ( = S ick S inus S yndrome ) may present. during which sinus bradycardia and arrhythmia are seen but not to a degree that produces symptoms. New slow AFib reflects a combination of these rhythm problems.

Atrial Fibrillation

Atrial Fibrillation AFIB Bradycardia Pacemaker

Conventional computer ECG algorithm misses another potentially deadly abnormality. How does AI perform?

Dr. Smith's ECG Blog

OCTOBER 24, 2024

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.

Dysrhythmia

Dysrhythmia Atrial Fibrillation Bradycardia Ablation

A teenager involved in a motor vehicle collision with abnormal ECG

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

I've copied KEY points from My Comment in the August 6, 2022 post in Dr. Smith's ECG Blog — regarding the answer to this question. 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.

Tachycardia

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia

What is strange about this paroxysmal atrial fibrillation in an otherwise healthy patient? And what happened after giving ibutilide?

Dr. Smith's ECG Blog

MARCH 15, 2023

. = 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.

Atrial Fibrillation

Atrial Fibrillation AFIB Arrhythmia Exercise

This middle-aged patient presented with SOB, weakness, and mild pulmonary edema.

Dr. Smith's ECG Blog

JANUARY 22, 2020

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.

Pulmonary

Pulmonary AFIB Atrial Fibrillation Pacemaker

20-something with huge verapamil overdose and cardiogenic shock

Dr. Smith's ECG Blog

MAY 26, 2023

This was a very complex case and the details are too much for an ECG Blog, but suffice it to say that, s hortly thereafter, the patient had an asystolic arrest and was resuscitated. He was placed on ECMO. Peak troponin I at 24 hours was 480 ng/L. Laddergram Illustration: The mechanism of AV block in ECG #2 is complex.

Cardiogenic Shock

Cardiogenic Shock Arrhythmia Blog Education

Wide-complex tachycardia: VT, aberrant, or "other?"

Dr. Smith's ECG Blog

DECEMBER 16, 2018

Additionally, her beta-blocker dose had been decreased because of bradycardia, further predisposing her to atrial flutter. For example: Statistical likelihood that the regular WCT in ECG #1 might be AFlutter ( instead of VT ) is greatly increased in a patient with AFib who is taking Flecainide.

Tachycardia

Tachycardia Atrial Flutter AFIB Atrial Fibrillation

How a pause can cause cardiac arrest

Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

I have periodically called attention to examples of the Ashman phenomenon as they occur in Dr. Smith's ECG Blog ( See My Comments in the January 5, 2020 post — the June 17, 2020 post — and the March 30, 2023 post , among others ).

Cardiac Arrest

Cardiac Arrest Cardiomyopathy Arrhythmia Atrial Fibrillation

Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

As we've discussed on numerous other posts in Dr. Smith's ECG Blog ( See My Comment at the bottom of the page in the May 5, 2022 post) — a growing number of conditions other than Brugada Syndrome have been found to temporarily produce a Brugada-1 ECG pattern. What are the ECG Findings of Cardiac Contusion?

Arrhythmia

Arrhythmia Blog Chest Pain Cardiac Arrest

This was texted to me in real time. The patient has acute chest pain.

Dr. Smith's ECG Blog

JULY 5, 2023

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.

Chest Pain

Chest Pain STEMI Congenital Heart Disease Heart Disease

Wide-complex tachycardia that didn’t follow the rules

Dr. Smith's ECG Blog

DECEMBER 23, 2019

Adenosine is safe in VT and may be useful in making the diagnosis. == MY Comment by K EN G RAUER, MD ( 12/23/2019 ): == It is ALWAYS great to welcome the contributions to Dr. Smith’s ECG Blog from Dr. Brooks Walsh — a highly skilled clinician + good friend and colleague who always stimulates conversation on important emergency medicine topics.

Tachycardia

Tachycardia Atrial Flutter Cardiomyopathy Atrial Fibrillation

What is this ECG finding? Do you understand it before you hear the clinical context?

How Wearable Tech Can Help Monitor Your Heart Health

A woman in her 50s with dyspnea and bradycardia

A woman in her 70s with bradycardia and hypotension

Syncope and Atrial fibrillation in a Healthy 70-something Male

Conventional computer ECG algorithm misses another potentially deadly abnormality. How does AI perform?

A teenager involved in a motor vehicle collision with abnormal ECG

What is strange about this paroxysmal atrial fibrillation in an otherwise healthy patient? And what happened after giving ibutilide?

This middle-aged patient presented with SOB, weakness, and mild pulmonary edema.

20-something with huge verapamil overdose and cardiogenic shock

Wide-complex tachycardia: VT, aberrant, or "other?"

How a pause can cause cardiac arrest

Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

This was texted to me in real time. The patient has acute chest pain.

Wide-complex tachycardia that didn’t follow the rules

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