Dr. Smith's ECG Blog

AUGUST 9, 2024

There are three mechanisms of arrhythmia: automatic, re-entry, and triggered. The most common triggered arrhythmia is Torsades de Pointes. Automatic activity refers to enhanced pacemaking function (typically from a non sinus node source), for example atrial tachycardia. This has been discussed many times before on this blog.

Chest Pain 88

Chest Pain Arrhythmia Myocardial Infarction STEMI 88

Ken Grauer, MD

JANUARY 20, 2024

Looking first at the long-lead II rhythm strip — there is significant bradycardia , with a heart R ate just under 40/minute. The patient may need a pacemaker. But the point to emphasize — is that it should only take seconds to recognize that there is bradycardia from significant AV block. =

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Blog Bradycardia STEMI Download 96

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. That is, until the 7th R wave which comes a little bit sooner than expected. CLICK HERE — for more on fusion beats.

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Chest Pain STEMI Bradycardia Ischemia 113

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. In the meantime, a pacemaker may be needed. = There definitel are periods of bradycardia (so pacing may be needed for that).

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Arrhythmia Heart Failure Bradycardia Pacemaker 78

Open Heart

JULY 17, 2023

Cardiac accumulation triggers local tissue injury, electrical instability and arrhythmia. Objective We conducted a systematic review evaluating AF burden and bradycardia requiring permanent pacemaker (PPM) implantation and report any predictive risk factors identified. Study outcomes included AF or bradycardia requiring therapy.

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Bradycardia Atrial Fibrillation Pacemaker Risk Factors 52

Dr. Smith's ECG Blog

NOVEMBER 11, 2023

I added, "Makes me wonder if this could be myocarditis in a younger adult — maybe even with sinus arrhythmia." That said, despite the group beating — the rhythm is not consistent with AV Wenckebach. Figure-1: The initial ECG in today's case.

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Stroke Strokes Chest Pain Cardiomyopathy 74

All About Cardiovascular System and Disorders

MAY 2, 2024

Athlete’s bradycardia due to increased parasympathetic tone and decreased sympathetic tone is a well-known observation. Though sinus bradycardia is usual, other abnormalities like sinus arrhythmia, sinus arrest, wandering atrial pacemaker and coronary sinus rhythm have been described.

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Exercise Cardiomyopathy Blood Pressure Physiology 40

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.

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Atrial Fibrillation AFIB Arrhythmia Exercise 52

Wellnest

DECEMBER 21, 2022

Arrhythmia In simple words, arrhythmia refers to an irregular heartbeat. A fast heartbeat is called tachycardia, while a slow heartbeat is called bradycardia in medical terms. ECG testing is also carried out to see how medicines work during treatment and the pacemaker's functioning.

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Cardiac Arrest Heart Attack Heart attacks Atrial Fibrillation 52

All About Cardiovascular System and Disorders

MAY 21, 2024

But subcutaneous ICD cannot provide bradycardia and antitachycardia pacing as a transvenous ICD. It was a multinational study which enrolled patients at risk for sudden death from ventricular arrhythmias and the follow up period was 6 months. of patients were free from leadless pacemaker related major complications.

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Pacemaker Defibrillator Bradycardia Arrhythmia 52

Dr. Smith's ECG Blog

JANUARY 13, 2024

Written by Willy Frick A man in his 70s with a history of HFrEF and sick sinus syndrome s/p dual chamber pacemaker placement was admitted for overnight observation following outpatient placement of a mitral valve clip. This is unambiguous evidence of pacemaker malfunction. Imagine the pacemaker is set at a minimum rate of 60.

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Pacemaker Bicuspid/Mitral Blood Pressure Hospital 104

Ken Grauer, MD

OCTOBER 13, 2023

Is a pacemaker needed? With P waves labeled — Isn't it now much easier to appreciate that the atrial rhythm is quite regular ( with no more than a slight sinus arrhythmia )? P utting I t A ll T ogether : The precise mechanism of today's arrhythmia is complex and difficult to determine. Is this " high -grade" AV block?

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Blog Arrhythmia Bradycardia Download 140

EMS 12-Lead

JUNE 1, 2022

He received a permanent pacemaker during the subsequent inpatient stay. plaque disruption), the T waves still manifest markings of a previous state of suboptimal coronary flow that resolved: Type II supply-demand mismatch in the setting of extreme bradycardia. Chapter 17: Ventricular Arrhythmias. References [1] Surawicz, B.

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Heart Failure Myocardial Infarction Bradycardia Cardiomyopathy 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.

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Atrial Fibrillation Arrhythmia Heart Failure Tachycardia 40

Ken Grauer, MD

OCTOBER 27, 2023

That said — obvious findings include: i ) Marked bradycardia! — My Immediate Impression — was that this elderly woman with a several week history of symptoms would most likely leave the hospital with a pacemaker. The rhythm in Figure-1 is complex — and defies precise interpretation without careful study. be regular! —

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Blog Pacemaker Bradycardia Arrhythmia 104

Dr. Smith's ECG Blog

JANUARY 23, 2024

Isoprenalin was discontinued, and a temporary transveous pacemaker was implanted. The patient stabilized following pacemaker placement. VT is the second most common presenting arrhythmia. Vaso or inotropic medications are not harmless, and can precipitate life threatening arrhythmias.

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Tachycardia Arrhythmia Heart Disease Sudden Cardiac Death 88

Ken Grauer, MD

JULY 18, 2024

Most of the time with AV block — the atrial rhythm will be regular ( or at least almost regular — if there is an underlying sinus arrhythmia ). PEARL # 5: As noted above — today's arrhythmia appears to represent some form of 2nd-degree AV block. Figure-4: I needed to draw a laddergram.

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Blog Arrhythmia Bradycardia Pacemaker 88

Dr. Smith's ECG Blog

APRIL 29, 2020

Therefore, she underwent temporary pacemaker placement and overdrive pacing at a rate of 90 bpm to keep the heart rate up in order to prevent these PVCs triggering ventricular arrhythmia. Hypokalemia was unlikely because she continued to have ventricular arrhythmia despite of correcting electrolytes.

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Cardiac Arrest Defibrillator Ischemia Tachycardia 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