Dr. Smith's ECG Blog

FEBRUARY 22, 2024

See our other countless hyperkalemia cases below: General hyperkalemia cases: A 50s year old man with lightheadedness and bradycardia Patient with Dyspnea. A woman with near-syncope, bradycardia, and hypotension What happens if you do not recognize this ECG instantly? Also: How did this happen? Is this just right bundle branch block?

Cardiac Arrest 140

Cardiac Arrest Bradycardia Tachycardia Chest Pain 140

Frontiers in Cardiovascular Medicine

JANUARY 10, 2024

Here, a rare repeated sinus bradycardia event due to escitalopram is first reported. She began to take escitalopram and lorazepam due to depression, but sinus bradycardia (93.7% Escitalopram was deemed to be a highly possible cause of sinus bradycardia according to its Naranjo's Algorithm score.

Bradycardia 64

Bradycardia Heart Disease Electrocardiogram Heart Rhythm 64

Medical Xpress - Cardiology

SEPTEMBER 13, 2024

Men who perform well in the cross-country ski race Vasaloppet are at increased risk of having abnormally low heart rates and pacemakers later in life. However, the researchers behind the study did not uncover any link to increased mortality, rather the opposite—the skiers lived longer than the general population.

Pacemaker 80

Pacemaker Bradycardia Research 80

Dr. Smith's ECG Blog

MAY 5, 2023

The "good" news — Treatment with naloxone will probably resolve the bradycardia. Figure-4: Review of the 2 long lead rhythm strips from today's case.

Bradycardia 52

Bradycardia Cardiac Arrest Arrhythmia Pacemaker 52

HeartRhythm

APRIL 30, 2024

Bradycardia-dependent block is characterized by slowed or blocked conduction through His-Purkinje (HPS) fibers. We describe a case of bradycardia-dependent block after transcatheter aortic valve replacement (TAVR). A proposed mechanism is the diseased HPS develops spontaneous depolarization during phase 4 of the action potential.

Bradycardia 40

Bradycardia TAVR Aortic valve Aortic 40

Circulation

NOVEMBER 11, 2024

Electrocardiogram (ECG) and telemetry revealed junctional bradycardia with heart rate in 30s and sinus pauses (5-7 seconds). He was admitted for further workup of bradycardia. His home medications included metoprolol succinate 25mg daily which was held given bradycardia. Initial laboratory analysis was unremarkable.

Bradycardia 40

Bradycardia Coronary Artery Disease Kidney Disease Outpatient 40

Open Heart

JULY 17, 2023

Objective We conducted a systematic review evaluating AF burden and bradycardia requiring permanent pacemaker (PPM) implantation and report any predictive risk factors identified. Study outcomes included AF or bradycardia requiring therapy. Databases included Embase, Medline, PubMed, Web of Science, CINAHL and Cochrane.

Bradycardia 52

Bradycardia Atrial Fibrillation Pacemaker Risk Factors 52

Medical Xpress - Cardiology

MAY 18, 2024

Wireless implantable cardioverter-defibrillators (ICDs) eliminate the lead-related complications that come with a wired ICD, but they are unsuitable for patients with ventricular tachycardia, when the heart beats too quickly, or bradycardia, when the resting heart rate is seen as low.

Bradycardia 100

Bradycardia Defibrillator Tachycardia 100

Journal of Cardiovascular Electrophysiology

FEBRUARY 13, 2024

Methods Consecutive patients with bradycardia indicated for pacing from 2016 to 2022 were prospectively followed for the clinical endpoints of heart failure (HF)-hospitalizations and all-cause mortality at 2 years. CSP should be preferred over VSP or RVP during pacing for bradycardia.

Bradycardia 40

Bradycardia Physiology Pacemaker Heart Failure 40

HeartRhythm

APRIL 30, 2024

We present a case series of two young patients with obesity-related comorbidities necessitating sleeve gastrectomy which provoked symptomatic sinus bradycardia. While weight loss following bariatric surgery often yields resolution of comorbidities related to obesity, it also presents unanticipated changes in underlying physiology.

Bradycardia 40

Bradycardia Obesity Physiology 40

ECG Guru

NOVEMBER 20, 2023

Let's analyze the ECG. It comes from a pacemaker patient whose pacemaker was briefly switched to VVI at 30 bpm due to a stimulation threshold test. The first 3 beats show a sinus rhythm with a frequency of approx. This is followed by a premature ventricular contraction (PVC).

Bradycardia 52

Bradycardia Pacemaker 52

Dr. Smith's ECG Blog

JANUARY 26, 2020

Her vital signs were within normal limits except for bradycardia at 55 bpm. It is probably sinus bradycardia with very small/depressed P-waves and prolonged PR interval. P EARL # 4 In my opinion, it is not worth wasting time trying to figure out the specific rhythm diagnosis of a bradycardia when there is hyperkalemia.

Bradycardia 52

Bradycardia Ischemia Cardiac Arrest AFIB 52

Dr. Smith's ECG Blog

JANUARY 19, 2020

Resuscitation was initiated and this ECG was obtained: Likely AFib (irregularly irregular) with bradycardia. In addition to marked bradycardia — could there be high-grade AV block? On arrival in the ED, she was profoundly hypotensive, nearly obtunded, and bradycardic.

Bradycardia 52

Bradycardia STEMI AFIB Pacemaker 52

HeartRhythm

SEPTEMBER 27, 2023

As the most common cause of syncope, vasovagal syncope (VVS) is the result of cerebral hypoperfusion caused by sudden-onset bradycardia and mediated by parasympathetic overdrive.1 1 VVS is generally categorized into three types: cardioinhibitory, vasodepressive and mixed type.

Bradycardia 40

Bradycardia 40

Dr. Smith's ECG Blog

NOVEMBER 9, 2018

For instance, if there were inappropriate sinus bradycardia at less than 60 bpm, the atrial pacer would take over if it is programmed to wait 1 second before firing. The atrial lead would pace if, after a programmed period of time, it did not sense an atrial beat (usually 1 second, corresponding to a rate of 60).

Bradycardia 52

Bradycardia Pacemaker Ischemia 52

Dr. Smith's ECG Blog

OCTOBER 7, 2019

Both of these features make inferior + RV MI by far the most likely ( Pseudoanteroseptal MI is another name for this ) There is also sinus bradycardia and t he patient is in shock with hypotension. A narrow complex bradycardia without any P-waves is also likely to respond to atropine, as it may be a junctional rhythm.

Bradycardia 40

Bradycardia STEMI Cardiogenic Shock Ischemia 40

HeartRhythm

APRIL 30, 2024

Among them, bradycardia and pause detection could be erroneous during sleep as the heart rate may slow down significantly leading to potential inappropriate diagnosis. Insertable cardiac monitors (ICMs) are used widely for long term monitoring and diagnosis of various cardiac arrhythmia.

Bradycardia 40

Bradycardia Arrhythmia 40

EMS 12-Lead

MAY 15, 2024

Crew notifies the received ED of an incoming post-arrest patient and notes a sinus bradycardia on their monitor, as seen in Figure 2. Figure 2 : This rhythm shows a sinus bradycardia at a rate between 30 and 40bpm. The crew immediately initiated TCP at a rate of 70bpm and slowly increased the current, as shown in Figure 3.

Atrial Fibrillation 132

Atrial Fibrillation Bradycardia Pacemaker Cardiac Arrest 132

Med Page Today

MAY 20, 2024

(MedPage Today) -- BOSTON -- A leadless pacemaker reliably communicated with a subcutaneous implantable cardioverter-defibrillator (S-ICD) to deliver anti-tachycardia (ATP) and bradycardia pacing, the MODULAR ATP study showed. In terms of safety.

Defibrillator 77

Defibrillator Bradycardia Pacemaker Tachycardia 77

ECG Guru

JULY 30, 2024

The ECG shows an example of a patient with bradycardia/tachycardia syndrome. Patients with bradycardia/tachycardia syndrome usually require a heart pacemaker to prevent the heart rate from becoming too slow. Initially, a sinus rhythm with a heart rate of approx. 70 bpm is seen. 120 bpm here). 120 bpm here).

Bradycardia 67

Bradycardia Tachycardia Pacemaker 67

Frontiers in Cardiovascular Medicine

DECEMBER 13, 2023

Background Rotational atherectomy (RA) during percutaneous coronary intervention may cause transient bradycardia or a higher-degree heart block. Traditionally, some operators use prophylactic transvenous pacing wire (TPW) to avoid haemodynamic complications associated with bradycardia.

Bradycardia 72

Bradycardia Diabetes Hospital 72

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.

Blog 78

Blog Bradycardia Arrhythmia Tachycardia 78

Frontiers in Cardiovascular Medicine

OCTOBER 9, 2024

The primary outcome was ventricular arrhythmias, the secondary outcomes were bradycardia and atrial fibrillation (AF).ResultsOur 0.66], but increased the risk of in-hospital bradycardia (OR 2.88, 95% CI 1.02–8.17) 0.66], but increased the risk of in-hospital bradycardia (OR 2.88, 95% CI 1.02–8.17) 8.17) compared with propofol.

Arrhythmia 52

Arrhythmia Bradycardia Atrial Fibrillation Hospital 52

Dr. Smith's ECG Blog

AUGUST 11, 2024

There’s competing sinus bradycardia and junctional rhythm, with otherwise normal conduction, borderline right axis, normal R wave progression and voltages. Significant bradycardia ( rate in the 40s/minute ) — is present throughout. What do you think? It’s unclear if the paramedic ECGs were seen or missed in the ED.

Chest Pain 82

Chest Pain STEMI Bradycardia Stent 82

Frontiers in Cardiovascular Medicine

OCTOBER 31, 2024

BackgroundThere have been few instances of symptomatic bradycardia-arrhythmia in the context of area postrema syndrome (APS), and some of them have been implanted permanent pacemakers. A total of 21 cases were identified in the final analysis (including our case). The average age was 51 years old and female patients accounted for 38.1%.

Bradycardia 52

Bradycardia Pacemaker Arrhythmia 52

American College of Cardiology

OCTOBER 17, 2024

Does prolonged, high-intensity endurance training increase the risk of bradycardia requiring pacemaker implantation and ultimately the long-term mortality risk?

Pacemaker 55

Pacemaker Bradycardia Article 55

ECG Guru

SEPTEMBER 10, 2023

A common cause of pauses and bradycardia are non-conducted PACs, which generally do not require treatment. Therefore, it is important to differentiate between pauses or bradycardia that require treatment.

Bradycardia 52

Bradycardia 52

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

Altered Mental Status, Bradycardia == MY Comment , by K EN G RAUER, MD ( 2/2 /2024 ): == Dr. Meyers began today’s case with the clinical challenge of asking you to identify the underlying cause of ECG #2. -- Read this ECG -- Osborn Waves and Hypothermia (this is the "Figure" above) What does LBBB look like in severe hypothermia?

Blog 137

Blog Cardiac Arrest Atrial Fibrillation Bradycardia 137

Ken Grauer, MD

OCTOBER 13, 2023

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 ). Finally — If today's patient does not have significant underlying coronary disease — then her bradycardia with AV block may be the result of SSS ( S ick S inus S yndrome ).

Blog 159

Blog Arrhythmia Bradycardia Download 159

HeartRhythm

APRIL 30, 2024

In-hospital cardiac arrest (IHCA) is a major healthcare problem with a high mortality rate. With continuous telemetry monitoring, heart rate trends could be used to predict IHCA events.

Cardiac Arrest 40

Cardiac Arrest Bradycardia Hospital 40

ECG Guru

DECEMBER 20, 2023

The first two beats are sinus node beats, there is a sinus bradycardia with approx. After this, the sinus bradycardia is re-established. We see the limb leads + V1/V2. Then there is a sinus arrest with a pause of 3000 ms, which is interrupted by a junctional escape beat.

Bradycardia 52

Bradycardia 52

American College of Cardiology

FEBRUARY 6, 2024

The following are key points to remember from a review article on cardiac implantable electronic devices (CIEDs), which include pacemakers for bradycardia, biventricular pacemakers for heart failure, and implantable cardioverter–defibrillators (ICDs) for the treatment of sudden cardiac death:

Sudden Cardiac Death 51

Sudden Cardiac Death Bradycardia Pacemaker Defibrillator 51

ECG Guru

OCTOBER 11, 2023

There is no P wave in front of each QRS, so this is not sinus bradycardia. If the patient is showing signs of poor perfusion, we would stop here and prepare to increase the rate with a temporary pacemaker (transvenous or transcutaneous). Why is the rate so slow?

Bradycardia 98

Bradycardia Pacemaker 98

DAIC

JUNE 20, 2024

A recently opened clinical trial called BACKBEAT (BradycArdia paCemaKer for Blood prEssure treAtmenT) aims to use Medtronic’s Astra and Azure model pacemakers to not only treat slow heart rates but also delivers electrical pulses stimulating the heart in a way that reduces the patient’s blood pressure.

Blood Pressure 105

Blood Pressure Pacemaker Research Hypertension 105

HeartRhythm

APRIL 30, 2024

Associations have been made between certain bradycardia and risk of strokes. The effect of bradycardia on stroke risk in atrial fibrillation is uncertain. Bradycardic syndromes often complicate atrial fibrillation.

Atrial Fibrillation 40

Atrial Fibrillation Bradycardia Strokes Stroke 40

HeartRhythm

FEBRUARY 27, 2024

Bradyarrhythmias including sinus bradycardia and atrioventricular (AV) block are frequently encountered in endurance athletes especially at night.

Bradycardia 40

Bradycardia Electrophysiology Pacemaker Arrhythmia 40

American College of Cardiology

MAY 24, 2024

Is a novel modular pacing–defibrillator system, consisting of a leadless pacemaker in wireless communication with a subcutaneous implantable cardioverter–defibrillator (ICD), able to effectively and safely provide antitachycardia and bradycardia pacing?

Defibrillator 46

Defibrillator Bradycardia Pacemaker Article 46