Dr. Smith's ECG Blog

JANUARY 2, 2025

Discontinue all negative chronotropic agents, since the risk of torsade is much higher with bradycardia or pauses. Finally, do a coronary angiogram Possible alternative to pacing is to give a beta-1 agonist to increase heart rate. Even with tachycardia and a paced QRS duration of ~0.16 The plan: 1. J Am Coll Cardiol.

Tachycardia 116

Tachycardia Cardiomyopathy Blog Bradycardia 116

EMS 12-Lead

MARCH 19, 2023

The shortened PR-interval, specifically, proved to be quite beguiling as it swept crews down a differential diagnosis of intermittent accessory pathway syndrome – insomuch as a “syndrome” of recurrent tachycardia to account for the patient’s symptoms. Learning points 1] Acute Coronary Syndrome has many shades of clinical manifestation.

Myocardial Infarction 52

Myocardial Infarction STEMI Coronary Angiogram Coronary Artery Disease 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

A coronary angiogram was done that did not show significant coronary artery disease. But there are 3 other wide beats in the tachycardia that begins with beat #6 ( = beats #7; 13,14 ). Post ROSC the patient was alert and cooperative. Echocardiography showed apical ballooning with hypokinesis.

Cardiac Arrest 68

Cardiac Arrest Cardiomyopathy Arrhythmia Atrial Fibrillation 68

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

During observation in the ED the patient had multiple self-terminating runs of Non-Sustained monomorphic Ventricular Tachycardia (NSVT). Below in Figure-5 is a 10-minute continuous lead II recording on oral Flecainide, now showing sinus bradycardia without a single PVC! CT coronary angiogram showed a hypoplastic RCA and dominant LCx.

Tachycardia 72

Tachycardia Arrhythmia Ablation Atrial Flutter 72