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Detection of Irregular Heart Rhythms Devices such as the Apple Watch or Fitbit Sense can detect irregular heart rhythms, including atrial fibrillation (AFib). These early warnings are critical, as AFib increases the risk of stroke and other heart-related complications.
Sinus tachycardia – sinus rhythm above 100 bpm is a sinus tachycardia. Sinus bradycardia – sinus rhythm below 60 bpm is a sinus bradycardia. Ventricular tachycardia – more than 7 consecutive complexes originating from ventricles at a rate of > 100 bpm. Usually does not exceed 160 bpm.
Wide-complex tachycardia: VT or aberrant, or "other?" A wide-complex tachycardia in an older patient must immediately suggest ventricular tachycardia. Sinus tachycardia with aberrancy was unlikely as the rate was consistently 150 bpm, without spontaneous variation. And indeed the QRS morphology strongly supported VT (e.g.
during which sinus bradycardia and arrhythmia are seen but not to a degree that produces symptoms. Thus, there is sinus bradycardia and arrhythmia sinus pauses ( which may be longlasting, ultimately leading to sinus arrest ) and SA nodal block. New slow AFib reflects a combination of these rhythm problems. second in duration.
The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. The Initial ECG in Today's Case: As per Dr. Meyers — the initial ECG in today's case shows sinus tachycardia with bifascicular block ( = RBBB/LAHB ). Sinus Tachycardia ( common in any trauma patient. ).
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.
But there are 3 other wide beats in the tachycardia that begins with beat #6 ( = beats #7; 13,14 ). Similar-looking wide beats #7,13,14 must also be aberrantly conducted supraventricular impulses — and since P waves are lost after beat #6 and subsequent R-R intervals are irregular — beats #7-thru-16 constitute a run of rapid AFib.
Sinus Tachycardia ( common in any trauma patient. ). Other Arrhythmias ( PACs, PVCs, AFib, Bradycardia and AV conduction disorders — potentially lethal VT/VFib ). RBBB ( as by far the most common conduction defect — owing to the more vulnerable anatomic location of the RV ).
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