Ken Grauer, MD

DECEMBER 23, 2023

KEY Point: Knowing that the most commonly overlooked arrhythmia is AFlutter — suggests that the BEST way to avoid missing the diagnosis of AFlutter is simply to THINK of AFlutter whenever you have a regular SVT at a rate close to 150/minute ( in which you do not clearly see upright sinus P waves in lead II ). And a Final Tracing.

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Blog Tachycardia Tricuspid Atrial Flutter 175

Ken Grauer, MD

JUNE 2, 2023

to 1828 msec. ) — which corresponds to a variation in the rate of sinus bradycardia from 36-to-33/minute. This makes sense given that the underlying rhythm in today's case appears to be marked sinus bradycardia and arrhythmia , with a ventricular escape rhythm appearing when the SA node rate drops below 33/minute.

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Blog Bradycardia Arrhythmia Tachycardia 78

Dr. Smith's ECG Blog

DECEMBER 16, 2018

Wide-complex tachycardia: VT or aberrant, or "other?" A wide-complex tachycardia in an older patient must immediately suggest ventricular tachycardia. Sinus tachycardia with aberrancy was unlikely as the rate was consistently 150 bpm, without spontaneous variation. second ), in which the tachycardia is sustained.

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Tachycardia Atrial Flutter AFIB Atrial Fibrillation 52

Dr. Smith's ECG Blog

DECEMBER 23, 2019

Initial ECG in the ED: Presenting ECG : Wide-complex tachycardia at a rate about 200. This is overwhelmingly likely to be ventricular tachycardia, even if only age and medical history are considered. Nevertheless, the widths of both the QRS complex and the RS duration are similar in both the old ECG and the tachycardia.

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Tachycardia Atrial Flutter Cardiomyopathy Atrial Fibrillation 52

MIBHS

JANUARY 31, 2025

Early detection of conditions like AFib, bradycardia, or tachycardia allows patients to address issues before they become critical. Risk Reduction Data from wearables can identify potential risks, such as undiagnosed arrhythmias or hypertension, allowing healthcare teams to address these issues before surgery.

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Heart Rhythm Technology AFIB Exercise 52

Dr. Smith's ECG Blog

JUNE 23, 2023

A 50-something male with unspecified history of cardiomyopathy presented in diabetic ketoacidosis (without significant hyperkalemia) with a wide complex tachycardia and hypotension. Analysis: there is a wide complex tachycardia. This was the interpretation I put into the system: WIDE COMPLEX TACHYCARDIA. It is regular.

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Tachycardia Cardiomyopathy Arrhythmia Diabetes 52

Dr. Smith's ECG Blog

JULY 5, 2018

during which sinus bradycardia and arrhythmia are seen but not to a degree that produces symptoms. The easy way to remember the arrhythmias most commonly associated with SSS is to think of what one might expect if the SA node became sick. The indication for pacemaker placement with SSS is symptomatic bradycardia.

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Atrial Fibrillation AFIB Bradycardia Pacemaker 52

Dr. Smith's ECG Blog

JANUARY 31, 2019

== P EARL # 1: The easiest way to instantly enhance your arrhythmia interpretation skills is by using calipers. The cardiologist who does not regularly use calipers for interpretation of complex arrhythmias is a cardiologist who will miss the diagnosis on more than a few occasions. Using calipers will NOT slow you down.

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Bradycardia Pacemaker Arrhythmia Tachycardia 52

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 86

Wellnest

JUNE 19, 2023

Similarly, you may use our , app to adjust the paper speed along with amplification to read the slightest changes, especially for conditions like tachycardia and bradycardia. Alternatively, it also helps enhance arrhythmia management with coronary artery disease. It improves the prediction model for myocardial scar mass.

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Technology Cardiac Arrest Innovation Coronary Artery Disease 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

Learning points : Takotsubo can lead to cardiac arrest from ventricular arrhythmia. But there are 3 other wide beats in the tachycardia that begins with beat #6 ( = beats #7; 13,14 ). The QTc then gradually shortened over the course of several days as is usual for stress cardiomyopathy.

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Cardiac Arrest Cardiomyopathy Arrhythmia Atrial Fibrillation 67

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

He has a family history concerning for arrhythmia. Given the circumstances of his car crash, we presume it was due to an underlying arrhythmia. He has a family history concerning for arrhythmia with his father requiring some sort of device (PPM, ICD, unclear) at a young age.

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Arrhythmia Blog Chest Pain Cardiac Arrest 52

Dr. Smith's ECG Blog

OCTOBER 15, 2024

Additionally, his cardiac telemetry monitor showed runs of accelerated idioventricular rhythm, a benign arrhythmia often associated with coronary reperfusion. He had multiple episodes of bradycardia and nonsustained ventricular tachycardia. As expected, the patient reported total resolution of pain by the time he got to the ED.

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Chest Pain STEMI Echocardiogram Stents 115

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

JANUARY 23, 2024

Shortly after isoprenalin infusion was initiated, there were short runs of ventricular tachycardia. VT is the second most common presenting arrhythmia. Vaso or inotropic medications are not harmless, and can precipitate life threatening arrhythmias. She was started on isoprenalin (isoproterenol).

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Tachycardia Arrhythmia Heart Disease Sudden Cardiac Death 106

Dr. Smith's ECG Blog

JULY 21, 2024

However, he suddenly developed a series of malignant ventricular arrhythmias. This progressed to electrical storm , with incessant PolyMorphic Ventricular Tachycardia ( PMVT ) and recurrent episodes of Ventricular Fibrillation ( VFib ). Below are printouts of some of the arrhythmias recorded. What do you think?

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Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 130

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.

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Chest Pain Arrhythmia Myocardial Infarction STEMI 106

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

Dr. Smith's ECG Blog

APRIL 8, 2016

There is also bradycardia. Bradycardia puts patients at risk for "pause-dependent" Torsades de Pointes. Torsades in acquired long QT is much more likely in bradycardia because the QT interval following a long pause is longer still. See here for management of Polymorphic Ventricular Tachycardia , which includes Torsades.

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STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Dr. Smith's ECG Blog

OCTOBER 25, 2023

ECG is consistent with severe hypokalemia and/or hypomagnesemia causing prolonged QT (QU) at high risk of Torsades (which is polymorphic ventricular tachycardia in the setting of a long QT interval). Polymorphic Ventricular Tachycardia Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management Cardiac Arrest. Is it STEMI?

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Chest Pain Ischemia Cardiac Arrest Blog 123

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The arrhythmia spontaneously converted before defibrillation was achieved. As per Dr. Nossen — today's initial ECG ( LEFT tracing in Figure-2 ) shows sinus bradycardia with QRS widening due to bifascicular block ( RBBB/LAHB ). The patient was rushed to the nearest emergency department (non-PCI facility) for stabilization.

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Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 127

Dr. Smith's ECG Blog

OCTOBER 8, 2023

I completely agree with Dr. Nossen that in this patient with new CP and sinus tachycardia with LAHB — that the T waves in each of the inferior leads are hyperacute ( ie, clearly disproportionately "bulky" given size of the QRS in these leads ). — and which other patient(s) need to be seen as soon as possible to figure out what is going on?

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Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 121

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. If your heart beats too slowly, too quickly, or irregularly, an ECG will easily detect it.

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Cardiac Arrest Heart Attack Heart attacks Atrial Fibrillation 52

All About Cardiovascular System and Disorders

MARCH 17, 2024

It can automatically detect life threatening ventricular arrhythmias and treat them, either with a shock or, sometimes by overdrive pacing. And, after the shock, if there is bradycardia, it can be covered by these two pacing electrodes, one at the tip, and one proximal to it. These are high voltage, defibrillator shock coils.

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Myocardial Infarction Defibrillator Sudden Cardiac Death Arrhythmia 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

Otherwise vitals after intubation were only notable for tachycardia. An initial EKG was obtained: Computer read: sinus tachycardia, early acute anterior infarct. Prior to Mizusawa's study, it was thought that the incidence of syncope, arrhythmia, or SCD in this cohort was low [7]. There was a 0.9% Circulation, 117, 1890–1893. [3]:

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Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

APRIL 8, 2015

If the patient has Abnormal Vital Signs (fever, hypotension, tachycardia, or tachypnea, or hypoxemia), then these are the primary issue to address, as there is ongoing pathology which must be identified. 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

Dr. Smith's ECG Blog

DECEMBER 5, 2019

There is sinus tachycardia and also a large R-wave in aVR. Drug toxicity , especially diphenhydramine , which has sodium channel blocking effects, and also anticholinergic effects which may result in sinus tachycardia, hyperthermia, delirium, and dry skin. Her temperature was 106 degrees. As part of the workup, she underwent an ECG.

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Sudden Cardiac Death Heart Rhythm Article Tachycardia 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

During observation in the ED the patient had multiple self-terminating runs of Non-Sustained monomorphic Ventricular Tachycardia (NSVT). The possibility of an ischemic cause of the ventricular arrhythmia has to be considered! A workup was undertaken in search of a cause of the patient's ventricular arrhythmia. No PVCs are seen.

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Dr. Smith's ECG Blog

JANUARY 21, 2023

This ECG shows a sinus bradycardia with a normal conduction pattern (normal PR, normal QRS, and normal QTc), normal axis, normal R-wave progression, normal voltages. Hypothermia can also produce bradycardia and J waves, with a pseudo-STEMI pattern. ECG met STEMI criteria and was labeled STEMI by computer interpretation.

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STEMI Bradycardia Arrhythmia Cardiac Arrest 52