article thumbnail

Case Report: Fatal atrioesophageal fistula following atrial fibrillation ablation—critical reflections on prevention

Frontiers in Cardiovascular Medicine

Head CT scans showed hypoattenuating areas indicative of cerebral infarction, chest CT suggested possible air accumulation in the left atrial region. ECG findings were consistent with atrial flutter, myocardial infarction, and incomplete right bundle branch block.

article thumbnail

Arrhythmia? Ischemia? Both? Electricity, drugs, lytics, cath lab? You decide.

Dr. Smith's ECG Blog

The axiom of "type 1 (ACS, plaque rupture) STEMIs are not tachycardic unless they are in cardiogenic shock" is not applicable outside of sinus rhythm. Therefore this patient is either in some form of SVT or atrial flutter. Atrial flutter, when regular, must be conducting at 1:1, 2:1, 3:1, etc. If so, why?

article thumbnail

A man in his 70s with acute chest pain and paced rhythm.

Dr. Smith's ECG Blog

LAFB, atrial flutter, anterolateral STEMI(+) OMI. Impella (cardiac output augmentation device) placed for cardiogenic shock Unfortunately, the patient progressed to multiorgan failure with worsening cardiac output despite being maxed on pressors and a balloon pump. He expired 4 days later.