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

Dr. Smith's ECG Blog

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?

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A woman in her 70s with bradycardia and hypotension

Dr. Smith's ECG Blog

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 ).

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Evaluation of atrial fibrillation using wearable device signals and home blood pressure data in the Michigan Predictive Activity & Clinical Trajectories in Health (MIPACT) Study: A Subgroup Analysis (MIPACT-AFib)

Frontiers in Cardiovascular Medicine

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. Of 76 participants assessed by the study team, 32 (42.1%) reported anxiety surrounding notifications. Cardiac monitor demonstrated AF in 2 of 3 participants with AF on Apple Watch EKGs.

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Cardiomatics guide: Analyzing arrhythmias made easy

Cardiomatics

Sinus bradycardia – sinus rhythm below 60 bpm is a sinus bradycardia. AFIB/AFL – atrial fibrillation or atrial flutter episodes. Sinus tachycardia – sinus rhythm above 100 bpm is a sinus tachycardia. In healthy individuals occurs during exercising or strong emotions. Usually does not exceed 160 bpm.

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

Dr. Smith's ECG Blog

. = 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.

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

Dr. Smith's ECG Blog

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.

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A teenager involved in a motor vehicle collision with abnormal ECG

Dr. Smith's ECG Blog

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. Atrial fibrillation is also a predictor of worse outcomes in this case (Alborzi). Sinus Tachycardia ( common in any trauma patient. ).