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. = 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.
The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. Circulation: Cardiovascular Imaging. Other Arrhythmias ( PACs, PVCs, AFib, Bradycardia and AV conduction disorders — potentially lethal VT/VFib ). Chest trauma was suspected on initial exam. 2015, March 1). Cramer, M.
The QRS is wide in B — but the rhythm is irregularly irregular with no sinus P waves — so this most probably represents rapid AFib with an atypical RBBB/LPHB morphology. We now see that QRS morphology in lead II during sinus rhythm is similar to the QRS morphology in lead II during rapid AFib (beats #1-5 in lead II in A). 8] Liu, E.,
There is no evidence of infarction or ischemia. Because the AP lies outside of the AV node — the time to circulate around the reentry pathway and conduct back to the atria ( retrograde ) is longer than when the entire reentry circuit is contained within the AV node. There are nonspecific ST-T abnormalities.
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