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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.
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?
The article is edited by Smith. Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. 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.
Abnormal Electrocardiogram (ECG): Defined (San Fran syncope rule) as any new changes when compared to the last ECG or presence of non-sinus rhythm. 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. starts at end of article on p.
Regardless of further evaluation, she should avoid bradycardia, AV nodal blockers, Na channel blockers, and fevers. --If Fever not only unmasks a Brugada-type electrocardiogram (ECG) but also increases the risk of ventricular tachyarrhythmias such as ventricular fibrillation (VF) or sudden cardiac death.
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