Remove Arrhythmia Remove Atrial Flutter Remove Ischemia
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Arrhythmia? Ischemia? Both? Electricity, drugs, lytics, cath lab? You decide.

Dr. Smith's ECG Blog

The rhythm differential for narrow, regular, and tachycardic is sinus rhythm, SVT (encompassing AVNRT, AVRT, atrial tach, etc), and atrial flutter (another supraventricular rhythm which is usually considered separately from SVTs). Therefore this patient is either in some form of SVT or atrial flutter.

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A young woman with palpitations. What med is she on? With what medication is she non-compliant? What management?

Dr. Smith's ECG Blog

Atrial flutter with 2:1 conduction. The atrial flutter rate is approximately 200 bpm, with 2:1 AV conduction resulting in ventricular rate almost exactly 100 bpm. Further history revealed she had new onset atrial flutter soon after her aortic surgery, and was put on flecainide approximately 1 month ago.

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Medics were criticized for not activating the cath lab

Dr. Smith's ECG Blog

Here I put arrows: Arrows shows slow atrial flutter waves. Arrhythmia? Today’s case recalled that scenario for me, in that it features recognition of an arrhythmia that fooled ED staff into thinking the ECG was showing an acute infarction. These mimic ST Elevation. But there is no STE. Would you give lytics?

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ECG Blog #370 — A Post-Arrest Tachycardia.

Ken Grauer, MD

A series of cardiac arrhythmias were seen during the course of her resuscitation — including the interesting arrhythmia shown in the long lead II of Figure-1. At about this point in the process — I like to take a closer LOOK at the 12-lead tracing, to ensure there is no acute ischemia or infarction that might need immediate attention.

Blog 78
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A woman in her 60s with large T-waves. Are they hyperacute, hyperkalemic, or something else?

Dr. Smith's ECG Blog

This narrows our differential for the rhythm down to sinus tachycardia, paroxysmal supraventricular tachycardia (PSVT, or SVT), and atrial flutter. The patient’s history is notable for paroxysmal atrial fibrillation, which raises clinical suspicion for atrial flutter, since these two entities frequently coexist on a spectrum.

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Back to basics: what is this rhythm? What are your options for treating this patient?

Dr. Smith's ECG Blog

We see a regular tachycardia with a narrow QRS complex and no evidence of OMI or subendocardial ischemia. The differential of a regular narrow QRS tachycardia is sinus tachycardia, SVT, and atrial flutter with regular conduction. There are no P waves preceding the QRS complexes, and no clear flutter waves.

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New Onset Heart Failure and Frequent Prolonged SVT. What is it? Management?

Dr. Smith's ECG Blog

There is a large peaked P-wave in lead II (right atrial enlargement) There is left axis deviation consistent with left anterior fascicular block. There is no evidence of infarction or ischemia. There is atrial activity before every QRS, but that activity has negative polarity, so it is not sinus rhythm.