Dr. Smith's ECG Blog

JULY 11, 2024

At this point, there was no improvement in LV function and he was out of the convalescent phase of his MI, so the decision was made to install an ICD for arrhythmia prophylaxis. An echocardiogram showed an EF of 20-25%. One month after ICD implantation, an EKG was taken: Notably, the T wave inversions are now resolved.

Outcomes 112

Outcomes Stenosis Outpatient Echocardiogram 112

DAIC

MAY 17, 2024

The EP-COT Trial: Impact of Emergent Physician Notifications from MCOT on Patient Outcomes While ambulatory cardiac monitors are frequently used to diagnose arrhythmias, their impact on clinical decision-making has not been extensively studied.

Heart Rhythm 52

Heart Rhythm Technology Arrhythmia Outcomes 52

Journal of Cardiovascular Electrophysiology

JANUARY 10, 2024

Follow-up contained regular visits at our outpatient clinic at 1, 3, 6, and 12 months including 7-day Holter electrocardiograms. After a blanking period of 6 weeks, recurrence of any atrial arrhythmia was documented in 26 patients (52%). Most arrhythmia recurrences were reentrant AT. After a total of 1.46 ± 0.68

Atrial Fibrillation 40

Atrial Fibrillation Ablation Outpatient Arrhythmia 40

Dr. Smith's ECG Blog

JULY 5, 2024

PEARL #1: The most commonly overlooked arrhythmia is AFlutter ( A trial F lutter ). That said — the lack of a terminal S wave in lateral limb leads I and aVL is atypical for true RBBB conduction. As a result — We can not rule out VT on the basis of this single ECG.

Atrial Flutter 112

Atrial Flutter Tachycardia Atrial Fibrillation AFIB 112

Dr. Smith's ECG Blog

APRIL 6, 2023

If the patient does not present with syncope, then outpatient management is probably OK, with referral to cardiology. Taking a Closer LOOK : There is a fairly marked sinus arrhythmia ( RED arrows in Figure-2 ). PEARL # 1: It is common with 2nd- and 3rd-degree AV block to see a "ventriculophasic" sinus arrhythmia.

Arrhythmia 52

Arrhythmia Atrial Fibrillation AFIB Outpatient 52

Dr. Smith's ECG Blog

SEPTEMBER 29, 2023

Hopefully his outpatient EP appointment will understand and correct that. MY point that is relevant to optimal arrhythmia interpretation — is to always look to see if there is a "break" in the rhythm at the onset or offset of the tachycardia — since if present, this will often tell you the specific diagnosis! was discovered.

Chest Pain 129

Chest Pain Tachycardia STEMI Blog 129

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. Cardiology was consulted, and the note said "no arrhythmias on telemetry or pacer interrogation." What do you think?

Pacemaker 110

Pacemaker Bicuspid/Mitral Blood Pressure Bradycardia 110

Dr. Smith's ECG Blog

APRIL 24, 2022

Case sent by Magnus Nossen MD, edits by Meyers A previously healthy woman in her 60s presented to an outpatient clinic for palpitations. Today's CASE: To Review — The patient in today’s case is a previously healthy woman in her 60s who was seen in an outpatient clinic for “palpitations”.

AFIB 52

AFIB Tachycardia Atrial Fibrillation Blog 52

Frontiers in Cardiovascular Medicine

MARCH 13, 2024

The issue is relevant since some arrhythmias are associated to sudden cardiac death occurring in young patients, and the overall risk does not cease during the early postpartum period. Both inpatients and outpatients were identified retrospectively. PVC were the most common recorder arrhythmias, followed by VF, NSVT, AF, CSD.

Cardiomyopathy 59

Cardiomyopathy Sudden Cardiac Death Arrhythmia Outpatient 59

Open Heart

SEPTEMBER 18, 2024

Introduction Wearable cardioverter-defibrillators (WCD) have emerged as a valuable tool in the management of patients at risk for life-threatening arrhythmias. Methods From November 2022 to May 2024, we conducted an outpatient follow-up of 41 patients receiving WCD. Among these, 12 patients (29%) underwent ICD implantation.

Defibrillator 52

Defibrillator Sudden Cardiac Death Arrhythmia Outpatient 52

Dr. Smith's ECG Blog

MARCH 24, 2023

Arrange follow up for chest pain patients who are “STEMI negative” with “normal troponin”: the patient was referred to outpatient cardiology But 6 hours later the patient returned with recurrent chest pain: Again diagnostic of infero-posterior OMI, though this time it does STEMI criteria, albeit barely. See analysis below.

Chest Pain 52

Chest Pain STEMI Bradycardia Ischemia 52

Dr. Anish Koka

FEBRUARY 20, 2023

It is relevant to note here that as a physician active clinically in both the inpatient and outpatient arenas, I am an eyewitness to the severe toll COVID19 took on my patients in the Spring or 2020.

COVID-19 52

COVID-19 Pericarditis Chest Pain Public Health 52

Dr. Smith's ECG Blog

NOVEMBER 11, 2024

Written by Willy Frick A middle aged man presented for elective outpatient surgery. To Emphasize: For those in search of "the quick answer" — today's middle-aged man should not be approved for an outpatient elective surgical procedure without further evaluation. The following ECG was obtained in the preoperative area.

Arrhythmia 70

Arrhythmia Bradycardia Outpatient Pacemaker 70

Dr. Smith's ECG Blog

JANUARY 9, 2025

But vasovagal syncope typically has a prodrome such that further evaluation of today's patient may be needed as an outpatient to better assess for the cause of his sudden syncope. The most common cause of syncope in a previously healthy young adult like today's patient is vasovagal syncope. Troponins were negative.

Chest Pain 106

Chest Pain Ischemia Dysrhythmia Arrhythmia 106

Dr. Smith's ECG Blog

DECEMBER 27, 2024

This is an arrhythmia until proven otherwise. He was discharged with a plan for outpatient PCI to his chronically occluded RCA. He complained of days to weeks of palpitations and dyspnea. His clinic ECG is shown. What do you think? In an elderly patient complaining of palpitations, we have an ECG with heart rate 140 bpm.

Tachycardia 120

Tachycardia Stents Stent Arrhythmia 120