Remove Aneurysm Remove Atrial Flutter Remove Pacemaker
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A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

Dr. Smith's ECG Blog

She also has a hx of paroxysmal atrial fibrillation and is on oral anticoagulant treatment. She had a single chamber ICD/Pacemaker implanted several years prior due to ventricular tachycardia. The ECG was interpreted as showing atrial flutter with 2:1 conduction. The last echocardiography 12 months ago showed HFmrEF.

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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Look for Vascular Etiology -- think of these while doing H and P: --Bleeding: ruptured AAA, GI bleed, ruptured ectopic pregnancy, other spontaneous bleed such as mesenteric aneurysms. Negative predictors included dementia, pacemaker, coronary revascularization, and cerebrovascular disease. Syncope with Exertion (EGSYS) 7.