HeartRhythm

MARCH 26, 2024

We read with great interest the article by Del Monte et-al.1 However, no predefined cutoff for temporary backup pacing was employed in the study and therefore it is difficult to establish the bradycardia severity. 1 and the associated editorial2.

Ablation 40

Ablation Atrial Fibrillation Bradycardia Article 40

American College of Cardiology

MAY 24, 2024

Is a novel modular pacing–defibrillator system, consisting of a leadless pacemaker in wireless communication with a subcutaneous implantable cardioverter–defibrillator (ICD), able to effectively and safely provide antitachycardia and bradycardia pacing?

Defibrillator 50

Defibrillator Bradycardia Pacemaker Article 50

Journal of Cardiovascular Electrophysiology

FEBRUARY 29, 2024

Abstract Introduction Left bundle branch pacing (LBBP) is a physiological pacing modality. However, the long procedure and fluoroscopy time of LBBP is still a problem. This study aims to compare the clinical outcomes between transthoracic echocardiography (TTE)- and X-ray-guided LBBP.

Bradycardia 40

Bradycardia Electrophysiology Outcomes Physiology 40

Dr. Smith's ECG Blog

NOVEMBER 24, 2017

This article discusses correction of the QT interval for rate. The article is written by Dr. Smith and Dr. Friedman. The rule of thumb is less accurate, and the risk is higher because a long QT in the presence of bradycardia ("pause dependent" Torsades) predisposes to Torsades. now an EM resident at Beth Israel.

Bradycardia 52

Bradycardia Article Atrial Fibrillation Chest Pain 52

Conquering CHD

JULY 11, 2023

A rapid heartbeat (tachycardia) can increase the workload on your heart, while a slow heartbeat (bradycardia) can cause fatigue and dizziness. Related Article: Medications for Congenital Heart Disease: What Every Parent Should Know Give Hope 365 Days a Year.

Congenital Heart Disease 52

Congenital Heart Disease Congenital Heart Disease Blood Clot 52

Dr. Smith's ECG Blog

MAY 5, 2022

Hyperkalemia causes peaked T waves and the "killer B's of hyperkalemia", including bradycardia, broad QRS complexes, blocks of the AV node and bundle branches, Brugada morphology, and otherwise bizarre morphology including sine wave. With a twist. Do you recognize this ECG yet? Right Bundle Branch Block with ST Elevation in V1?

Chest Pain 52

Chest Pain Bradycardia Cardiac Arrest STEMI 52

Journal of Cardiovascular Electrophysiology

APRIL 10, 2025

Methods The TriNetX database (Jan 2015June 2023) was queried to include adults receiving their first single-chamber ventricular pacemaker for heart block, bradycardia, sick sinus syndrome, atrial fibrillation, or syncope, excluding those with prior pacemakers, heart failure or enrolled for research settings.

Pacemaker 40

Pacemaker Heart Failure Atrial Fibrillation Bradycardia 40

Journal of Cardiovascular Electrophysiology

DECEMBER 17, 2024

Methods Thirty-seven patients with a pacemaker indication for bradycardia or cardiac resynchronization therapy underwent LBBAP implantation. ECG, vectorcardiogram, ECG belt and UHF-ECG signals were recorded during RVP, LVSP and LBBP, and intrinsic activation.

Electrophysiology 40

Electrophysiology Bradycardia Pacemaker Article 40

Dr. Smith's ECG Blog

FEBRUARY 15, 2018

Here are inferior leads, and aVL, magnified: A closer inspection of the inferior leads and aVL Sinus bradycardia. Normal QRS-T angle From this article: Ziegler R and Bloomfield DK. Yes, there are valuable articles from 50 years ago! I had no history on the case and no prior ECG for comparison. What do you think?

Chest Pain 52

Chest Pain Critical Care Article Pacemaker 52

Journal of Cardiovascular Electrophysiology

MARCH 31, 2025

ABSTRACT Introduction Leadless pacemakers (LPs) are a valuable treatment for bradycardia, with the Aveir offering advanced features, including a protective sleeve and active fixation. The higher impedance during the implantation was a strong predictor of a midterm favorable PCT.

Pacemaker 40

Pacemaker Bradycardia Outcomes Article 40

Journal of Cardiovascular Electrophysiology

DECEMBER 1, 2023

Abstract Introduction Severe transitory episodes of bradycardia with subsequent syncope in children are common, and generally portend a benign prognosis. Rarely, patients may experience prolonged asystolic episodes secondary to significant sinus pauses (SP) or paroxysmal atrioventricular block (AVB).

Pediatrics 40

Pediatrics Document Bradycardia Pacemaker 40

Journal of Cardiovascular Electrophysiology

MARCH 3, 2024

Patients who received pacemakers for an advanced atrioventricular block or bradycardia with atrial fibrillation, baseline LV ejection fraction (LVEF) ≥ 50%, and echocardiogram recorded at least 6 months postimplantation were included. The paced QRS recorded immediately after implantation was analyzed.

Cardiomyopathy 40

Cardiomyopathy Pacemaker Heart Rhythm Atrial Fibrillation 40

Journal of Cardiovascular Electrophysiology

DECEMBER 7, 2023

years during which 14 patients (18%) experienced VA requiring treatment ( n  = 14) or syncope due to bradycardia ( n  = 2). Patients were followed for 1.6 ± 1.5 Four/9 patients (44%) with MVP experienced VA ( n  = 3) or syncope ( n  = 1). 95% confidence interval: [1.2–27], 27], p  = 0.03, log-rank p  = 0.03).

Arrhythmia 40

Arrhythmia Outcomes Bradycardia Bicuspid/Mitral 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. However, this review references the Sterns article above, which by my reading does not state this.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

European Journal of Heart Failure

NOVEMBER 22, 2023

Hypotension, bradycardia, kidney dysfunction and hyperkalaemia were the main causes of underprescription and/or underdosing, but up to a half of the patients did not receive target doses for unknown causes (51%, 41%, and 55% for BB, ACEi/ARB/ARNI and MRA, respectively).

Heart Failure 40

Heart Failure Bradycardia Hospital Outcomes 40

Dr. Smith's ECG Blog

MAY 19, 2020

There is sinus bradycardia with one PVC. Also notice that the arterial line mean arterial pressure is 63 mmHg, but there is no waveform (and SpO2 says "no pulse"), as the flow is continuous on ECMO and the LV function at this point was extremely poor, unable to add a pulse pressure. She then had a 12-lead: What do you think?

Defibrillator 52

Defibrillator Circulation Plaque Cardiac Arrest 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

The article is edited by Smith. This was submitted by Alexandra Schick. Dr. Schick is a PGY3 at the Brown Emergency Medicine Residency in Rhode Island. I remember Allie well from her days in the Research volunteer program at Hennepin. Title: Is it just hot in here or is it a OMI? This patient ruled out for MI.

Heart Rhythm 52

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

DECEMBER 20, 2013

There does not seem to be good evidence to answer this question, unfortunately. I will be the first to admit that it feels good to make a relatively rare diagnosis based on interpreting squiggly lines on a piece of paper. How do we know that the benefits outweigh the risks of anticoagulation? Does subsegmental pulmonary embolism matter?

Pericarditis 52

Pericarditis Chest Pain Pulmonary STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

Other Arrhythmias ( PACs, PVCs, AFib, Bradycardia and AV conduction disorders — potentially lethal VT/VFib ). Figure-1 : Visual summary of ECG Patterns in Brugada Syndrome ( adapted from the article by Brugada et al in JACC: Vol. Sinus Tachycardia ( common in any trauma patient. ).

Arrhythmia 52

Arrhythmia Blog Chest Pain Cardiac Arrest 52

Dr. Smith's ECG Blog

MARCH 15, 2023

Ibutilide can convert atrial fib, or if the atrial fib is resistant to electrical cardioversion, ibutilide can facilitate electrical cardioversion (see my description of the New England Journal article below). Baseline bradycardia in endurance athletes limits the use of ß-blockers. Here is the ECG after ibutilide: What do you notice?

Atrial Fibrillation 52

Atrial Fibrillation AFIB Arrhythmia Exercise 52

Dr. Smith's ECG Blog

APRIL 15, 2019

Here is an excerpt from the article: "Normally, only 15% of coronary blood flow occurs during systole, and because myocardial bridging is a systolic event on angiography, its clinical significance and relevance have been questioned.

Tachycardia 40

Tachycardia STEMI Chest Pain Ischemia 40

Dr. Smith's ECG Blog

MARCH 24, 2023

There’s sinus bradycardia, first degree AV block, normal axis, delayed R wave progression, and normal voltages. Hyperacute T waves are deflating, suggesting reperfusion but there is still reciprocal change in I/aVL and ST depression in V2, and the bradycardia is worse. Below is the ECG. What do you think? Take home 1.

Chest Pain 52

Chest Pain STEMI Bradycardia Ischemia 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.

Arrhythmia 52

Arrhythmia Outcomes Chest Pain Risk Factors 52

Dr. Smith's ECG Blog

MAY 23, 2022

Patient 2 : 55 year old with 5 hours of chest pain radiating to the shoulder, with nausea and shortness of breath ECG: sinus bradycardia, normal conduction, normal axis, normal R wave progression, no hypertrophy. Smith : The fact that the ECG did not evolve is further proof that this was the baseline ECG. nearly identical to the first case).

Chest Pain 52

Chest Pain Pericarditis STEMI Arrhythmia 52

Dr. Smith's ECG Blog

DECEMBER 5, 2019

Regardless of further evaluation, she should avoid bradycardia, AV nodal blockers, Na channel blockers, and fevers. --If --Genetic testing could be helpful to confirm the diagnosis and allow for screening of other at-risk family members. --EP EP study to further risk stratify her is recommended, with ICD placement depending on the results.

Sudden Cardiac Death 52

Sudden Cardiac Death Heart Rhythm Article Tachycardia 52

Dr. Smith's ECG Blog

MARCH 8, 2025

Within ten minutes, she developed bradycardia, hypotension, and ST changes on monitor. Bradycardia and heart block are very common in RCA OMI. There was indication of parasympathetic overdrive ( the acute inferior STEMI with profound bradycardia and junctional escape ). He told the patient this horrible news.

Cardiomyopathy 75

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia 75

Dr. Smith's ECG Blog

MARCH 19, 2025

Despite the baseline artifact theres sinus bradycardia, convex ST elevation in III, reciprocal ST depression in aVL and possible anterior ST depression indicating inferoposterior OMI. See our article here. Influenza-like illness can also trigger plaque rupture. The right precordial leads V1-V3 tell you all you need to know.

Chest Pain 116

Chest Pain STEMI Stents Stent 116

Journal of Cardiovascular Electrophysiology

NOVEMBER 10, 2024

The most common indications for S-ICD extraction were the need for bradycardia pacing (frequency among extractions, 18.2%), infection (22.7%), and inappropriate shocks due to oversensing (22.7%). There were 22 (5.9%) patients (81.8% male; 52.1 ± 13.2 years old) who underwent S-ICD extraction over a median follow-up period of 4.4 [2.0−6.5]

Bradycardia 40

Bradycardia Defibrillator Article 40

Dr. Smith's ECG Blog

FEBRUARY 4, 2025

Perhaps because the bradycardia in vasovagal syncope is only one part of the autonomic response. Phase 4 block is also referred to as "bradycardia dependent block." If you wish to read more about this, check out the references section at the bottom, especially the articles by Lee and Pillai. A stunning result.

Pacemaker 84

Pacemaker Bradycardia Document Heart Rhythm 84