Dr. Smith's ECG Blog

JANUARY 2, 2025

Discontinue all negative chronotropic agents, since the risk of torsade is much higher with bradycardia or pauses. Finally, do a coronary angiogram Possible alternative to pacing is to give a beta-1 agonist to increase heart rate. The plan: 1. See this post: How a pause can cause cardiac arrest 2. Place temporary pacemaker 3.

Tachycardia 117

Tachycardia Cardiomyopathy Blog Bradycardia 117

Dr. Smith's ECG Blog

JUNE 5, 2024

IMPRESSION: The finding of sinus bradycardia with 1st-degree AV block + marked sinus arrhythmia + the change in PR interval from beat #5-to-beat #6 — suggests a form of vagotonic block ( See My Comment in the October 9, 2020 post in Dr. Smith's ECG Blog ). Initial high sensitivity troponin I returned at 6ng/L (normal 0.20

Chest Pain 124

Chest Pain Blog Cardiac Arrest Cardiomyopathy 124

Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

A coronary angiogram was done that did not show significant coronary artery disease. Learning points : Takotsubo can lead to cardiac arrest from ventricular arrhythmia. Post ROSC the patient was alert and cooperative. Echocardiography showed apical ballooning with hypokinesis.

Cardiac Arrest 69

Cardiac Arrest Cardiomyopathy Arrhythmia Atrial Fibrillation 69

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

The possibility of an ischemic cause of the ventricular arrhythmia has to be considered! Below in Figure-5 is a 10-minute continuous lead II recording on oral Flecainide, now showing sinus bradycardia without a single PVC! A workup was undertaken in search of a cause of the patient's ventricular arrhythmia. No PVCs are seen.

Tachycardia 73

Tachycardia Arrhythmia Atrial Flutter Ablation 73