Dr. Smith's ECG Blog

JANUARY 5, 2020

Here is the computer interpretation: ATRIAL FIBRILLATION WITH RAPID VENTRICULAR RESPONSE WITH ABERRANT CONDUCTION OR VENTRICULAR PREMATURE COMPLEXES LEFT AXIS DEVIATION [QRS AXIS beyone -30] NONSPECIFIC ST and T-WAVE ABNORMALITY The over-reading physician confirmed this diagnosis, which is incorrect. It is not atrial fibrillation.

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Atrial Fibrillation Tachycardia Arrhythmia Pulmonary 52

Dr. Smith's ECG Blog

FEBRUARY 18, 2024

Written by Willy Frick A woman in her 90s with a history of end stage renal disease and complete heart block status post dual chamber pacemaker presented from home with acute onset dyspnea. In this case, it is atrial fibrillation. As per Dr. Frick — pacemaker spikes are best seen in lead aVL of ECG #1. ECG is shown below.

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Pacemaker Blog Atrial Fibrillation Electrophysiology 109

Dr. Smith's ECG Blog

MARCH 15, 2023

Her Apple Watch suddenly told her that she is in atrial fibrillation. Patients with healthy AV nodes who are not on AV nodal blockers and who are not hyperkalemic should have a rapid ventricular response if they have paroxysmal Atrial fibrillation. Exam was completely normal except for an irregular heart rate.

Atrial Fibrillation 52

Atrial Fibrillation AFIB Arrhythmia Exercise 52

Open Heart

JULY 28, 2023

Introduction The incidence of arrhythmia in heart failure with non-reduced ejection fraction (HFnon-rEF) in patients who have a history of hospitalisation is unclear. Methods and analysis This is a multicentre single arm study to evaluate the usefulness of ILR for detecting arrhythmia.

Atrial Fibrillation 40

Atrial Fibrillation Arrhythmia Heart Failure Tachycardia 40

Circulation

NOVEMBER 11, 2024

This can initiate ventricular arrhythmias like polymorphic ventricular tachycardia (PMVT). Given the LV-RV offset of 40 msec, she would have received these two tightly coupled pacemaker spikes in an asynchronous mode, in this unfortunate instance during her T wave. Telemetry showed pacer spikes initiating PMVT.

Tachycardia 40

Tachycardia Pacemaker Defibrillator Atrial Fibrillation 40

Dr. Smith's ECG Blog

OCTOBER 23, 2023

T wave alternans is characterized by variation in T-wave morphology in the setting of consistent pacemaker and QRS morphology. (1) T-wave alternans and the susceptibility to ventricular arrhythmias. Chronic amiodarone evokes no torsade de pointes arrhythmias despite QT lengthening in an animal model of acquired long-QT syndrome.

Tachycardia 131

Tachycardia Cardiac Arrest ICU Blog 131

Dr. Smith's ECG Blog

JANUARY 22, 2020

She previously had Atrial fibrillation with LBBB. This shows atrial fibrillation. The fact that the response is regular proves that the atrial fibrillation is NOT conducting. When atrial fib conducts, the ventricular rate must always be irregular. She had a permanent pacemaker implanted.

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Pulmonary AFIB Atrial Fibrillation Pacemaker 52

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

JANUARY 9, 2024

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 patient is female in her 80s with a medical hx of previous MI with PCI and stent placement. small squares in width (260ms).

Tachycardia 119

Tachycardia Electrophysiology Atrial Flutter Ischemia 119

Circulation

NOVEMBER 10, 2023

Among 299 patients with CRT-pacemakers (BVP-111, LBBAP-188), VT/VF occurred in 8 patients in the BVP group vs. none in the LBBAP group (7.2% Physiologic resynchronization by LBBAP may be associated with lower risk of arrhythmias compared with BVP. The occurrence of VT/VF was significantly lower with LBBAP compared with BVP (4.2%

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Atrial Fibrillation Pacemaker Physiology Heart Failure 40

Dr. Smith's ECG Blog

SEPTEMBER 29, 2023

Unfortunately the patient was erroneously diagnosed with "SVT / atrial fibrillation" and put on apixaban!!! See more posts on the atrial repolarization wave: K. Wang Video lecture: the Atrial Repolarization Wave (Ta Wave) Look at this ST Depression Atrial Repolarization Wave Mimicking ST Depression What is this ST Depression?

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Chest Pain Tachycardia STEMI Blog 130

Journal of Cardiovascular Electrophysiology

FEBRUARY 10, 2025

ABSTRACT Background Catheter ablation (CA) for atrial fibrillation (AF) in the elderly poses a growing challenge. Methods Octogenarians with AF or consecutive atrial tachycardia undergoing index or re-ablation (pulmonary vein isolation [PVI] and ablation beyond PVI with different energy sources) in a single center, were analyzed.

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Atrial Fibrillation Ablation Outcomes Pacemaker 40

Dr. Smith's ECG Blog

APRIL 8, 2015

Negative predictors of adverse outcome: Pacemaker Pre-syncope or "near-syncope," but there is still some small risk (5, 18) These last two are identified in studies, but I consider them dangerous signs and symptoms in their own right, as above: 10. The most recent and probably best study is this: Canadian Syncope Arrhythmia Risk Score.

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Arrhythmia Outcomes Risk Factors Chest Pain 52

Dr. Smith's ECG Blog

DECEMBER 20, 2024

How does a pacemaker accomplish RBBB morphology? Quick aside on device terminology (feel free to skip): A "single chamber" pacemaker is a device with only one lead. A "dual chamber" pacemaker is a device with an atrial lead and a ventricular lead. By ignoring this, the pacemaker reduces the likelihood of PMT.

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Chest Pain Tachycardia Pacemaker Defibrillator 102