Dr. Smith's ECG Blog

MARCH 15, 2023

Her Apple Watch suddenly told her that she is in atrial fibrillation. Patients with healthy AV nodes who are not on AV nodal blockers and who are not hyperkalemic should have a rapid ventricular response if they have paroxysmal Atrial fibrillation. Baseline bradycardia in endurance athletes limits the use of ß-blockers.

Atrial Fibrillation 52

Atrial Fibrillation AFIB Arrhythmia Exercise 52

Dr. Smith's ECG Blog

OCTOBER 24, 2024

This ECG shows sinus bradycardia with massively long QT (or QU?) Especially when present in the setting of bradycardia and syncopal episodes, this is very worrisome for high risk of lethal dysrhythmias including polymorphic ventricular fibrillation (termed Torsades when in the setting of long QT). interval, at over 600 msec.

Dysrhythmia 110

Dysrhythmia Atrial Fibrillation Bradycardia Ablation 110

Dr. Smith's ECG Blog

MAY 22, 2024

Learning points: Your differential for wide QRS (by itself) and bradycardia (by itself) must include hyperkalemia. The patient was a man in his 80s with chief complaint listed as: "hyperglycemia, weakness, ground level fall." ECG #1 @ 15:30 What do you think? Labs resulted, showing a potassium of 8.0 He was discharged home several days later.

Nursing 114

Nursing ICU Atrial Fibrillation Bradycardia 114

Dr. Smith's ECG Blog

OCTOBER 26, 2015

Due to bradycardia, a 12-lead ECG was obtained: There is atrial fibrillation at a rate of 54. But because of bradycardia, a 12-lead was obtained, which gave the critical diagnosis. Slow atrial fibrillation implies an sick AV node, or one affected by electrolytes, ischemia, or medications/drugs.

Atrial Fibrillation 52

Atrial Fibrillation Bradycardia Ischemia 52

MIBHS

JANUARY 31, 2025

Detection of Irregular Heart Rhythms Devices such as the Apple Watch or Fitbit Sense can detect irregular heart rhythms, including atrial fibrillation (AFib). Early detection of conditions like AFib, bradycardia, or tachycardia allows patients to address issues before they become critical.

Heart Rhythm 52

Heart Rhythm Technology AFIB Exercise 52

HeartRhythm

APRIL 30, 2024

Cardiac effects include bradycardia and AV conduction delay. It has been reported to unmask WPW in asymptomatic patients or facilitate rapid conduction of atrial fibrillation in WPW presumably by causing selective AV node conduction delay.

Ablation 40

Ablation Atrial Fibrillation Bradycardia 40

Open Heart

JULY 28, 2023

The aim of this study is to investigate the usefulness of an implantable loop recorder (ILR) for arrhythmia detection including atrial fibrillation (AF) in HFnon-rEF patients after discharge. Methods and analysis This is a multicentre single arm study to evaluate the usefulness of ILR for detecting arrhythmia.

Atrial Fibrillation 40

Atrial Fibrillation Arrhythmia Heart Failure Tachycardia 40

HeartRhythm

MARCH 26, 2024

However, no predefined cutoff for temporary backup pacing was employed in the study and therefore it is difficult to establish the bradycardia severity.

Ablation 40

Ablation Atrial Fibrillation Bradycardia Article 40

HeartRhythm

NOVEMBER 27, 2024

In a case report published in 1984 in the New England Journal of Medicine, Figure 1 was an electrocardiogram that showed sinus bradycardia with a short PR interval and prominent delta waves, with a pattern of preexcitation typical of a posteroseptal accessory pathway (PSAP).1

Electrocardiogram 40

Electrocardiogram Atrial Fibrillation Bradycardia Ablation 40

Circulation: Arrhythmia and Electrophysiology

NOVEMBER 10, 2023

Background:Despite chronic therapies, atrial fibrillation (AF) leads to rapid ventricular rates (RVR) often requiring intravenous treatments. Circulation: Arrhythmia and Electrophysiology, Ahead of Print.

Atrial Fibrillation 40

Atrial Fibrillation Bradycardia Electrophysiology Arrhythmia 40

Cardiomatics

APRIL 5, 2024

Sinus bradycardia – sinus rhythm below 60 bpm is a sinus bradycardia. AFIB/AFL – atrial fibrillation or atrial flutter episodes. Sinus tachycardia – sinus rhythm above 100 bpm is a sinus tachycardia. In healthy individuals occurs during exercising or strong emotions.

Arrhythmia 92

Arrhythmia Tachycardia Bradycardia Electrocardiogram 92

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Atrial fibrillation is also a predictor of worse outcomes in this case (Alborzi). Other Arrhythmias ( PACs, PVCs, AFib, Bradycardia and AV conduction disorders — potentially lethal VT/VFib ). RBBB in blunt chest trauma seems to be indicative of several RV injury. Sinus Tachycardia ( common in any trauma patient. ).

Tachycardia 115

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia 115

Physiologically Speaking

JULY 26, 2024

REM Sleep: Each percent increase in nightly REM sleep duration was associated with a lower risk of atrial fibrillation, atrial flutter, and bradycardia (an abnormally slow heart rhythm). Deep sleep: Each percent increase in deep sleep was associated with a lower risk of atrial fibrillation, depression, and anxiety.

Chronic Disease 64

Chronic Disease Physiology Atrial Flutter Atrial Fibrillation 64

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

Wellnest

DECEMBER 21, 2022

Atrial Fibrillation Atrial fibrillation causes irregular heartbeat, and the heart's normal blood supply is affected. Since atrial fibrillation can also be intermittent, such patients should continuously monitor their heart activity while performing daily activities with a portable ECG device.

Cardiac Arrest 52

Cardiac Arrest Heart Attack Heart attacks Atrial Fibrillation 52

Dr. Smith's ECG Blog

JANUARY 22, 2020

She previously had Atrial fibrillation with LBBB. This shows atrial fibrillation. The fact that the response is regular proves that the atrial fibrillation is NOT conducting. When atrial fib conducts, the ventricular rate must always be irregular. There is a regular, slow response. Hyperkalemia.

Pulmonary 52

Pulmonary AFIB Atrial Fibrillation Pacemaker 52

Dr. Smith's ECG Blog

NOVEMBER 24, 2017

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. 6) Use a different rule of thumb for bradycardia : Manually approximate both the QT and the RR interval. 3) At heart rates below 60, far more caution is due. Musat DL et al.

Bradycardia 52

Bradycardia Article Atrial Fibrillation Chest Pain 52

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The rhythm now is atrial fibrillation. 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 ). A repeat ECG was recorded about 15 minutes after the initial ECG. What do you think has happened and what is the most likely diagnosis?

Cardiogenic Shock 128

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128

Dr. Smith's ECG Blog

OCTOBER 8, 2023

Another frequent feature of hypothermia is atrial fibrillation (not seen in this case) Core temperature of this patient was 29,5 Celsius. Prominent J waves of this morphology thus are called Osborn waves. Severe hypothermia not uncommonly has accompanying T waves inversions. Troponins were negative in serial blood tests.

Ischemia 123

Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 123

Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

Note: Due to the limited number of normally conducted beats — it is hard to be sure whether the underlying rhythm is sinus with baseline artefact or atrial fibrillation. Note: The patient while on telemetry had alternating atrial fibrillation, sinus rhythm with 1st degree AV block and also periods of Wenckebach conduction.

Cardiac Arrest 68

Cardiac Arrest Cardiomyopathy Arrhythmia Atrial Fibrillation 68

All About Cardiovascular System and Disorders

APRIL 14, 2024

Echocardiographic assessment of left ventricular diastolic function with special reference on diastolic function assessment in atrial fibrillation. Use of drugs producing bradycardia like beta blockers in stages III and IV may precipitate low output state. Initial stages (I to III) are considered reversible with treatment.

Bicuspid/Mitral 52

Bicuspid/Mitral Pulmonary Atrial Fibrillation Ultrasound 52

Dr. Smith's ECG Blog

MAY 30, 2023

Here is his ED ECG: There is bradycardia with a junctional escape. What is the atrial activity? Or is it atrial fibrillation with complete AV block and junctional escape? Case continued A bedside ultrasound showed diminished LV EF and of course bradycardia. He appeared gray in color, with cool skin.

Chest Pain 97

Chest Pain Myocardial Infarction STEMI Cardiogenic Shock 97

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

Other commonly associated ECG features with Hypothermia include: i ) Bradycardia ( which may be marked ); ii ) Atrial fibrillation or other arrhythmias; iii ) Artifact ( from baseline undulations resulting from associated shivering ); iv ) QTc prolongation ( which may be marked ); and , v ) ST elevation in multiple leads.

Cardiac Arrest 40

Cardiac Arrest Bradycardia Chest Pain Ischemia 40

Dr. Smith's ECG Blog

DECEMBER 23, 2019

Detail of Flutter waves The rate of the flutter waves matches the rate of the WCT (about 200/m), proving that the presenting WCT had been 1:1 atrial flutter. The subsequent EP study could not induce VT, only atrial fibrillation. Spontaneous 1:1 atrial flutter Atrial flutter usually has a rate of 300 F/m.

Tachycardia 52

Tachycardia Atrial Flutter Cardiomyopathy Atrial Fibrillation 52

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. There is atrial fibrillation. mEq/L: The STE is resolved.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Dr. Smith's ECG Blog

DECEMBER 16, 2018

The patient had a history of paroxysmal atrial fibrillation and several cardioversions. Additionally, her beta-blocker dose had been decreased because of bradycardia, further predisposing her to atrial flutter. This case is contributed by Brooks Walsh , an EM physician and ECG expert from Connecticut.

Tachycardia 52

Tachycardia Atrial Flutter AFIB Atrial Fibrillation 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

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. There is marked sinus bradycardia. What do you think? As per Drs.

STEMI 52

STEMI Bradycardia Arrhythmia Cardiac Arrest 52

Dr. S. Venkatesan MD

NOVEMBER 22, 2024

Atrial fibrillation: Think locally act globally It is clear, except in specific situations like HT, LVH, HFpEF, and other left (or right )sided structural heart diseases, the bulk of the AF is part of systemic destabilization of neuro-metabolic homeostasis. Epicardial Fat and Atrial Fibrillation: A Review. 2017.11.001.

Atrial Fibrillation 52

Atrial Fibrillation Arrhythmia Risk Factors Bradycardia 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. 2:34 PM, following right heart catheterization She then went into atrial fibrillation with complete heart block and junctional escape rhythm prompting placement of transvenous pacemaker.

Cardiomyopathy 75

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia 75