Ken Grauer, MD
SEPTEMBER 22, 2023
KEY Point: Although true that patients with longstanding, severe pulmonary disease may manifest a QRST complex in standard lead I with marked overall reduction in QRST amplitude ( See ECG Blog #65 — regarding Schamroth’s Sign ) — you should never normally see a completely flat line in any of the standard limb leads.
Ken Grauer, MD
OCTOBER 13, 2023
To do this — I apply the P s, Q s, 3 R Approach ( See ECG Blog #185 — for review of my system ). Even if we stopped here — We could conclude the following: There is marked bradycardia in today's rhythm ( ie, Heart rate in the low 30s ). Clinical correlation to sort this all out will clearly be needed. =
Ken Grauer, MD
DECEMBER 23, 2023
By the P s, Q s, 3 R Approach ( See ECG Blog #185 ): The rhythm is fast and QRS complexes are R egular. PEARL # 4: As emphasized in ECG Blog #204 , in which I review derivation of the bundle branch blocks — RBBB is a terminal conduction delay. ECG Blog #185 — Reviews the P s, Q s, 3 R Approach to Rhythm Interpretation.
Ken Grauer, MD
AUGUST 26, 2023
I see the following: The rhythm is sinus bradycardia at ~55-60/minute. PEARL # 1: As I've emphasized often in this ECG Blog — the course of acute MI from acute coronary occlusion — is often staggered. PEARL # 1: As I've emphasized often in this ECG Blog — the course of acute MI from acute coronary occlusion — is often staggered.
Ken Grauer, MD
OCTOBER 27, 2023
That said — obvious findings include: i ) Marked bradycardia! — Given this patient's older age — if nothing "fixable" is found, she most likely has SSS ( S ick S inus S yndrome ) and will need a pacemaker ( See ECG Blog #342 for more on SSS ). See ECG Blog #188 for review on how to read and/or draw Laddergrams ). be regular! —
Ken Grauer, MD
JULY 18, 2024
It's important to appreciate that we can not rule out the possibility that this rhythm represents Mobitz II 2nd-degree AV block, in which case the patient will need a pacemaker ( See ECG Blog #236 — for review on the ECG diagnosis of the 2nd-degree AV Blocks ). ECG Blog #192 — The 3 Causes of AV Dissociation. STEP-by-STEP.
Ken Grauer, MD
JUNE 2, 2023
to 1828 msec. ) — which corresponds to a variation in the rate of sinus bradycardia from 36-to-33/minute. This makes sense given that the underlying rhythm in today's case appears to be marked sinus bradycardia and arrhythmia , with a ventricular escape rhythm appearing when the SA node rate drops below 33/minute.
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