Dr. Smith's ECG Blog

FEBRUARY 2, 2024

Written by Pendell Meyers First try to interpret this ECG with no clinical context: The ECG shows an irregularly irregular rhythm, therefore almost certainly atrial fibrillation. After an initially narrow QRS, there is a very large abnormal extra wave at the end of the QRS complex. Is there a long QT? How would you manage this patient?

Cardiac Arrest 132

Cardiac Arrest Blog Atrial Fibrillation Bradycardia 132

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Atrial fibrillation is also a predictor of worse outcomes in this case (Alborzi). Other Arrhythmias ( PACs, PVCs, AFib, Bradycardia and AV conduction disorders — potentially lethal VT/VFib ). NOTE: Prediction of cardiac contusion "severity" on the basis of cardiac arrhythmias and ECG findings — is an imperfect science.

Tachycardia 107

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia 107

Wellnest

DECEMBER 21, 2022

Atrial Fibrillation Atrial fibrillation causes irregular heartbeat, and the heart's normal blood supply is affected. Since atrial fibrillation can also be intermittent, such patients should continuously monitor their heart activity while performing daily activities with a portable ECG device.

Cardiac Arrest 52

Cardiac Arrest Heart Attack Heart attacks Atrial Fibrillation 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

Note: Due to the limited number of normally conducted beats — it is hard to be sure whether the underlying rhythm is sinus with baseline artefact or atrial fibrillation. Note: The patient while on telemetry had alternating atrial fibrillation, sinus rhythm with 1st degree AV block and also periods of Wenckebach conduction.

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Cardiac Arrest Cardiomyopathy Arrhythmia Atrial Fibrillation 68

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

Sci 5[4] 268-270, 2015 ) both highlight a likely association between acute development of ischemic J waves — and high risk of developing malignant ventricular arrhythmias.

Cardiac Arrest 52

Cardiac Arrest Bradycardia Chest Pain Ischemia 52

Dr. Smith's ECG Blog

JANUARY 21, 2023

This ECG shows a sinus bradycardia with a normal conduction pattern (normal PR, normal QRS, and normal QTc), normal axis, normal R-wave progression, normal voltages. Hypothermia can also produce bradycardia and J waves, with a pseudo-STEMI pattern. ECG met STEMI criteria and was labeled STEMI by computer interpretation.

STEMI 52

STEMI Bradycardia Arrhythmia Cardiac Arrest 52

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The rhythm now is atrial fibrillation. The arrhythmia spontaneously converted before defibrillation was achieved. As per Dr. Nossen — today's initial ECG ( LEFT tracing in Figure-2 ) shows sinus bradycardia with QRS widening due to bifascicular block ( RBBB/LAHB ). In the initial ECG (ECG# 1) aVR had ST elevation.

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Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 125

Dr. Smith's ECG Blog

OCTOBER 8, 2023

Another frequent feature of hypothermia is atrial fibrillation (not seen in this case) Core temperature of this patient was 29,5 Celsius. Prominent J waves of this morphology thus are called Osborn waves. Severe hypothermia not uncommonly has accompanying T waves inversions. Troponins were negative in serial blood tests.

Ischemia 109

Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 109

Dr. Smith's ECG Blog

DECEMBER 23, 2019

Detail of Flutter waves The rate of the flutter waves matches the rate of the WCT (about 200/m), proving that the presenting WCT had been 1:1 atrial flutter. The subsequent EP study could not induce VT, only atrial fibrillation. Spontaneous 1:1 atrial flutter Atrial flutter usually has a rate of 300 F/m.

Tachycardia 52

Tachycardia Atrial Flutter Cardiomyopathy Atrial Fibrillation 52

Circulation: Arrhythmia and Electrophysiology

NOVEMBER 10, 2023

Circulation: Arrhythmia and Electrophysiology, Ahead of Print. Background:Despite chronic therapies, atrial fibrillation (AF) leads to rapid ventricular rates (RVR) often requiring intravenous treatments.

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Atrial Fibrillation Bradycardia Electrophysiology Arrhythmia 40

Dr. Smith's ECG Blog

DECEMBER 16, 2018

The patient had a history of paroxysmal atrial fibrillation and several cardioversions. Additionally, her beta-blocker dose had been decreased because of bradycardia, further predisposing her to atrial flutter. This case is contributed by Brooks Walsh , an EM physician and ECG expert from Connecticut.

Tachycardia 52

Tachycardia Atrial Flutter AFIB Atrial Fibrillation 52

Dr. Smith's ECG Blog

APRIL 8, 2015

PVCs N ot generally considered abnormal ECG findings: Isolated PAC, First Degree AV Block, Sinus bradycardia at a rate of 35-45, and Nonspecific ST-T abnormalities (even if different from a previous ECG). Thus, if there is documented sinus bradycardia, and no suspicion of high grade AV block, at the time of the syncope, this is very useful.

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Arrhythmia Outcomes Risk Factors Chest Pain 52