Ken Grauer, MD

SEPTEMBER 15, 2024

For full discussion of the case — CLICK HERE — ECG Rhythm Overview: A 12-year-old boy was admitted to our hospital with severe myocardial dysfunction and chaotic rhythm with tachy- and bradycardic arrhythmias. There definitel are periods of bradycardia (so pacing may be needed for that).

Arrhythmia 78

Arrhythmia Bradycardia Heart Failure Pacemaker 78

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. As described above by Dr. Smith Pacing in today's case is an effective intervention as doing so prevents the bradycardia and pauses that are likely to precipitate additional episodes of Torsades de Pointes. (

Tachycardia 116

Tachycardia Cardiomyopathy Blog Bradycardia 116

Dr. Smith's ECG Blog

MARCH 22, 2024

I will leave more detailed rhythm discussion to the illustrious Dr. Ken Grauer below, but this use of calipers shows that the rhythm interpretation is: Sinus bradycardia with a competing (most likely junctional) rhythm. Neverthelss, his anterior wall was saved and he had normal ejection fraction without heart failure.

Chest Pain 114

Chest Pain STEMI Bradycardia Ischemia 114

Dr. Smith's ECG Blog

MARCH 15, 2023

Baseline bradycardia in endurance athletes limits the use of ß-blockers. The Role of Sinus Arrhythmia: I found it interesting to compare the long lead II rhythm strips in the 3 serial tracings from today’s case ( Figure-1 ). Note fairly marked irregularity of the R-R interval — indicative of definite sinus arrhythmia.

Atrial Fibrillation 52

Atrial Fibrillation AFIB Arrhythmia Exercise 52

Dr. Smith's ECG Blog

JANUARY 22, 2020

There are 3 etiologies I always think of with bradycardia and AV block: 1. While the diagnosis of SSS may become readily apparent early on in many patients clear indication for pacing usually does not become established until there is profound, symptomatic bradycardia usually requiring pauses of at least 3.0 Hyperkalemia.

Pulmonary 52

Pulmonary AFIB Atrial Fibrillation Pacemaker 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

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The arrhythmia spontaneously converted before defibrillation was achieved. The patient spent a couple of days in the cardiac intensive care unit receiving treatment for acute heart failure and aspiration pneumonia. How did the Queen of Hearts do on today's ECGs? Long term follow up is not available.

Cardiogenic Shock 128

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128