Remove Bradycardia Remove Cardiac Arrest Remove Circulation
article thumbnail

1 hour of CPR, then ECMO circulation, then successful defibrillation.

Dr. Smith's ECG Blog

There is sinus bradycardia with one PVC. There is "Shark Fin morphology" I saw this and thought for certain that this was going to be an LAD or left main occlusion as etiology of arrest, and etiology of profound ST Elevation in I, II, aVL, and V3-V6, and ST depression in III, V1 and V2. She then had a 12-lead: What do you think?

article thumbnail

Transcutaneous Pacing: Part 2

EMS 12-Lead

Patient had an unwitnessed cardiac arrest without bystander CPR performed. After 13 minutes of ALS resuscitation, pulses were palpated indicating a return of spontaneous circulation. Crew notifies the received ED of an incoming post-arrest patient and notes a sinus bradycardia on their monitor, as seen in Figure 2.

article thumbnail

STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes

Dr. Smith's ECG Blog

There is also bradycardia. Bradycardia puts patients at risk for "pause-dependent" Torsades de Pointes. Torsades in acquired long QT is much more likely in bradycardia because the QT interval following a long pause is longer still. If cardiac arrest from hypokalemia is imminent (i.e., mEq/L, from 1.9

STEMI 52
article thumbnail

What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

There was no evidence bradycardia leading up to the runs of PMVT ( as tends to occur with Torsades ). If there had been — a temporary atrial pacemaker could have been considered as a way of increasing the heart rate to suppress a bradycardia-dependent arrhythmia ("overdrive pacing").

article thumbnail

QT Correction Formulas Compared to The Rule of Thumb ("Half the RR")

Dr. Smith's ECG Blog

The rule of thumb is less accurate, and the risk is higher because a long QT in the presence of bradycardia ("pause dependent" Torsades) predisposes to Torsades. 6) Use a different rule of thumb for bradycardia : Manually approximate both the QT and the RR interval. 3) At heart rates below 60, far more caution is due.

article thumbnail

Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

Circulation, 117, 1890–1893. [3]: In addition to a spontaneous or induced Brugada-1 ECG pattern, criteria for B rugada S yndrome require one or more of the following: History of cardiac arrest, of polymorphoic VT, or of non-vagal syncope — positive family history of sudden death at an early age — a similar ECG in close relatives.