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Interpreting the waves and detecting abnormalities: Typically, the heart conducts electricity in a pathway starting in the sinoatrial node (SA), our heart’s “natural pacemaker”, located in the wall of the right atrium. AFIB/AFL – atrial fibrillation or atrialflutter episodes.
She also has a hx of paroxysmal atrial fibrillation and is on oral anticoagulant treatment. She had a single chamber ICD/Pacemaker implanted several years prior due to ventricular tachycardia. The ECG was interpreted as showing atrialflutter with 2:1 conduction. The last echocardiography 12 months ago showed HFmrEF.
Negative predictors of adverse outcome: Pacemaker Pre-syncope or "near-syncope," but there is still some small risk (5, 18) These last two are identified in studies, but I consider them dangerous signs and symptoms in their own right, as above: 10. QRS Syncope with Exertion (EGSYS) 7. S yncope while supine (EGSYS) 8. orthostatic vitals b.
How does a pacemaker accomplish RBBB morphology? Quick aside on device terminology (feel free to skip): A "single chamber" pacemaker is a device with only one lead. A "dual chamber" pacemaker is a device with an atrial lead and a ventricular lead. By ignoring this, the pacemaker reduces the likelihood of PMT.
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