Remove Atrial Flutter Remove Hypertension Remove Pulmonary
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Atrial dilatation in Atrial fibrillation : A query with multiple twists!

Dr. S. Venkatesan MD

Both atria develop from a combination of the primitive atrium, sinus venous, and pulmonary veins.It A fibrillatory wave that occurs at a rate of more than 600 beats per minute can cause fatigue in the long run, leading to atrial dilation. In all probability, this dilation is a form of atrial tachycardia and atrial cardiomyopathy.

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Too fast, too furious

Heart BMJ

Initial assessment with electrocardiography revealed a regular narrow complex tachycardia with 2:1 atrioventricular (AV) relationship, no clear isoelectric baseline and positive P waves in lead V1 consistent with an atrial flutter of left atrial origin with a rapid ventricular rate (~160/min) ( figure 1A ).

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Wide Complex Tachycardia -- VT, SVT, or A Fib with RVR? If SVT, is it AVNRT or AVRT?

Dr. Smith's ECG Blog

male with pertinent past medical history including Atrial fibrillation, atrial flutter, cardiomyopathy, Pulmonary Embolism, and hypertension presented to the Emergency Department via ambulance for respiratory distress and tachycardia. Bedside ultrasound showed volume depletion and no pulmonary edema.

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What does the ECG show in this patient with chest pain, hypotension, dyspnea, and hypoxemia?

Dr. Smith's ECG Blog

The bedside echo showed a large RV (Does this mean there is a pulmonary embolism as the etiology?) The rhythm is 2:1 atrial flutter. The flutter waves can conceal or mimic ischemic repolarization findings, but here I don't see any obvious findings of OMI or subendocardial ischemia. Lots of info here.

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Ischemic ST depression maximal in V1-V4 (vs. V5-V6), even if less than 0.1 millivolt, is specific for Occlusion Myocardial Infarction (vs. subendocardial non-occlusive ischemia)

Dr. Smith's ECG Blog

A 50-something man with history only of alcohol abuse and hypertension (not on meds) presented with sudden left chest pain, sharp, radiating down left arm, cramping, that waxes and wanes but never goes completely away. To me, this looks like pulmonary edema. B-line predominance bilateral lungs indicates pulmonary edema.

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Atrial fibrillation? Multifocal Atrial Tachycardia? Don't look at computer read until AFTER you interpret!

Dr. Smith's ECG Blog

M Y A NSWER: In my experience, MAT is the 2nd-most commonly overlooked cardiac arrhythmia ( surpassed only by Atrial Flutter ). The KEY to getting this patient better will doubtlessly include optimizing pulmonary function. = Q UESTION : Why is M AT ( M ultifocal A trial T achycardia ) so commonly overlooked? GET a 12-lead!

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Multielectrode Radiofrequency Balloon Catheter for Paroxysmal Atrial Fibrillation: Results From the Global, Multicenter, STELLAR Study

Journal of Cardiovascular Electrophysiology

This prospective, multicenter study conducted in the United States, Italy, and China investigated the safety and efficacy of pulmonary vein isolation (PVI) using HELIOSTAR in drug-refractory symptomatic PAF. Central Illustration. The primary safety endpoint was the occurrence of early-onset primary adverse events (PAEs).