Dr. Smith's ECG Blog

OCTOBER 26, 2020

12 minutes later, the patient went back into VFib arrest and underwent another 15 minutes of resuscitation followed by successful defibrillation and sustained ROSC. In total, he received approximately 40 minutes of CPR and 7 defibrillation attempts. An ICD was placed due to suspicion of a primary arrhythmia.

Ischemia 40

Ischemia Arrhythmia Defibrillator Chest Pain 40

Dr. Smith's ECG Blog

JULY 21, 2024

However, he suddenly developed a series of malignant ventricular arrhythmias. He required multiple defibrillations within a period of a few hours. Below are printouts of some of the arrhythmias recorded. There is no definite evidence of acute ischemia. (ie, What do you think?

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Ken Grauer, MD

JUNE 27, 2024

What is the most likely cause of this arrhythmia? Acute myocardial ischemia. Despite prolonged resuscitation with multiple defibrillation attempts — the patient could not be saved. = He developed cardiac arrest shortly after the ECG in Figure-1 was recorded. QUESTIONS: How would YOU interpret the ECG in Figure-1 ?

Blog 160

Blog Cardiac Arrest Sudden Cardiac Death Tachycardia 160

MIBHS

OCTOBER 31, 2024

This may result in ischemia (lack of oxygen to the heart muscle), causing parts of the heart to weaken and enlarge. Arrhythmias (Irregular Heartbeats) Persistent abnormal heart rhythms can disrupt the heart’s pumping efficiency, eventually causing it to enlarge to maintain blood flow.

Blood Pressure 52

Blood Pressure Blood Clot Heart Valves Heart Rhythm 52

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The first task when assessing a wide complex QRS for ischemia is to identify the end of the QRS. The ST segment changes are compatible with severe subendocardial ischemia which can be caused by type I MI from ACS or potentially from type II MI (non-obstructive coronary artery disease with supply/demand mismatch). What do you think?

Cardiogenic Shock 128

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128

Dr. Smith's ECG Blog

JUNE 13, 2024

V1 sits over both the RV and the septum, so transmural ischemia of either one with give OMI pattern in V1 and reciprocal STD in V5 and V6. Case progression: The automated EKG interpretation was “sinus rhythm with sinus arrhythmia, right atrial enlargement, rightward axis, possible anterior infarct, age undetermined, abnormal ECG”.

Chest Pain 92

Chest Pain Document STEMI Defibrillator 92

Dr. Smith's ECG Blog

JANUARY 23, 2024

Extensive conduction system abnormalities can have various causes (ischemia, genetic, infectious, amyloid, etc). She was given CRT-D (Cardiac Resynchronization Therapy-Defibrillator). VT is the second most common presenting arrhythmia. It is common with 2nd- and 3rd-degree AV block to see a " ventriculophasic " sinus arrhythmia.

Tachycardia 107

Tachycardia Arrhythmia Heart Disease Sudden Cardiac Death 107

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

There are a number of things to look for in an ECG that can hint at arrhythmia as the cause of an apparent seizure. This episode self terminated before defibrillation was possible. Below are some of the conditions to be aware of: Preexcitation Brugada syndrome. Arrhythmogenic cardiomyopathy Long QT syndrome Hypertrophic cardiomyopathy.

Tachycardia 113

Tachycardia Blog Sudden Cardiac Death Arrhythmia 113

Dr. S. Venkatesan MD

FEBRUARY 20, 2024

In myocardial pathology, the genesis and sustainability of ventricular arrhythmia are intricately related to the degree of LV dysfunction of any cause. Tackling SCD was in God’s domain, until the brilliance of Dr. Michel Mirowski shrunk the defibrillator and implanted it under the chest in 1980. (Dr. N Engl J Med. N Engl J Med.

Defibrillator 52

Defibrillator Heart Failure Sudden Cardiac Death Cardiomyopathy 52

Dr. Smith's ECG Blog

APRIL 8, 2016

At cath, he immediately had incessant Torsades de Pointes requiring defibrillation 7 times and requiring placement of a transvenous pacer for overdrive pacing at a rate of 80. If there is polymorphic VT with a long QT on the baseline ECG, then generally we call that Torsades, but Non-Torsades Polymorphic VT can result from ischemia alone.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Dr. Smith's ECG Blog

MAY 6, 2019

Followup ECG: No Change Absence of evolution is the best evidence against ischemia as the etiology. I was taught that the tell-tale sign of ischemia vs an electrical abnormality was in the hx, i.e. chest pain for the ischemia and potential syncope for brugada. Ischemia/infarction. Cardioversion/defibrillation.

Chest Pain 52

Chest Pain STEMI Ischemia Myocardial Infarction 52

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

The patient was put on Extracorporeal Life Support in the ED 3 hours after initial resuscitation, the core temp was 30° C and the patient was defibrillated with a single attempt. On arrival, CPR was continued and core temperature was measured at 18° C (64.4° A 12-lead ECG was recorded: There is sinus rhythm with RBBB and right axis deviation.

Cardiac Arrest 40

Cardiac Arrest Bradycardia Chest Pain Ischemia 40

Dr. Smith's ECG Blog

JANUARY 30, 2019

Prior to Mizusawa's study, it was thought that the incidence of syncope, arrhythmia, or SCD in this cohort was low [7]. In light of the risk of arrhythmia events observed in the Mizusawa trial, a formal EP study might be reasonable to obtain in those with fever induced asymptomatic Brugada ECG changes to help risk stratify these patients.

Heart Rhythm 52

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

DECEMBER 20, 2024

No evidence for ischemia jumps out. This is the shock coil and identifies this device as a defibrillator. CRT-D is cardiac resynchronization therapy with defibrillation capability, like the CXR above. CRT-P is cardiac resynchronization therapy with pacing only, without the ability to defibrillate. ECG 1 What do you think?

Chest Pain 102

Chest Pain Tachycardia Pacemaker Defibrillator 102

Dr. Smith's ECG Blog

DECEMBER 31, 2024

The ECG shows sinus rhythm with normal QRS complex morphology and significant subendocardial ischemia (SEI) pattern (ST depression in many leads, worst in lateral areas including leads II, V5-6, with reciprocal STE in aVR). Here is her ECG within 30 minutes of PCI: Improved, but still with ischemia. Pre-intervention. Post-intervention.

Ischemia 119

Ischemia Tachycardia Chest Pain STEMI 119

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

The possibility of an ischemic cause of the ventricular arrhythmia has to be considered! That said there were no clinical symptoms or ECG findings suggestive of ongoing ischemia. A workup was undertaken in search of a cause of the patient's ventricular arrhythmia. The idiopathic VTs are an interesting group of arrhythmias!

Tachycardia 72

Tachycardia Arrhythmia Atrial Flutter Ablation 72