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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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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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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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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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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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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. ).

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

Dr. Smith's ECG Blog

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.