Atrial Fibrillation Bradycardia Ischemia 
Dr. Smith's ECG Blog
JULY 5, 2018
PMH: Known paroxysmal Atrial fib. He is usually is in sinus rhythm as far as he knows, but he cannot subjectively feel atrial fibrillation, so he is never completely certain when he is in sinus or atrial fib. Here is his ECG: Atrial Fib with a Ventricular Response of about 66. He immediately completely recovered.
Dr. Smith's ECG Blog
FEBRUARY 2, 2024
Written by Pendell Meyers First try to interpret this ECG with no clinical context: The ECG shows an irregularly irregular rhythm, therefore almost certainly atrial fibrillation. After an initially narrow QRS, there is a very large abnormal extra wave at the end of the QRS complex. Is there a long QT? How would you manage this patient?
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.
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.
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?
Dr. Smith's ECG Blog
FEBRUARY 6, 2024
The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. 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 ).
Dr. Smith's ECG Blog
OCTOBER 8, 2023
Remember, in diffuse subendocardial ischemia with widespread ST-depression there may b e ST-E in lead s aVR and V1. There are well formed R-waves with good voltage/amplitude which is uncommon for ischemia. The ECG does not show any signs of ischemia. True Positive ECG#2 : Also sinus rhythm. There is ST depression in V1.
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