Dr. Smith's ECG Blog

JANUARY 5, 2024

The ECG shows sinus bradycardia but is otherwise normal. He first noticed it while exercising. Written by Willy Frick A 46 year old man with a history of type 2 diabetes mellitus presented to urgent care with complaint of "chest burning." The documentation does not describe any additional details of the history. No labs were obtained.

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Angina Plaque Document Stent 120

Dr. Smith's ECG Blog

FEBRUARY 23, 2023

After the heart rate increased slightly, here was the repeat ECG: Sinus bradycardia, only slightly faster rate than prior. That said — what is unusual about the rhythm in the initial ECG of today's case — is the marked bradycardia! Whether this is the result of a vasovagal reaction to the patient's abdominal pain? —

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Blog Bradycardia Ischemia Exercise 52

EMS 12-Lead

JUNE 1, 2022

plaque disruption), the T waves still manifest markings of a previous state of suboptimal coronary flow that resolved: Type II supply-demand mismatch in the setting of extreme bradycardia. 2] Although the clinical context in today’s case does not fit these descriptors for Type I OMI (e.g. Phase IV block, or concealed transeptal conduction).

Heart Failure 52

Heart Failure Myocardial Infarction Bradycardia Chest Pain 52

Dr. Smith's ECG Blog

MARCH 15, 2023

Whereas at low to moderate degrees of exercise, the risk of developing AFib in younger athletic individuals is reduced — there appears to be a “threshold” for exercise intensity with longterm endurance training, beyond which the risk of developing AFib paradoxically increases!

Atrial Fibrillation 52

Atrial Fibrillation AFIB Arrhythmia Exercise 52

Dr. Smith's ECG Blog

DECEMBER 22, 2022

He visited an outpatient clinic for it and an echocardiogram and exercise stress test was normal. His first electrocardiogram ( ECG) is given below: --Sinus bradycardia. His medical history is unremarkable except a similar pain occurred 4-5 times in the previous 3 months with less intensity, short duration, unrelated to exertion.

STEMI 52

STEMI Chest Pain Myocardial Infarction Electrocardiogram 52

Dr. Smith's ECG Blog

DECEMBER 23, 2019

Exercise can convert atrial flutter from 2:1 conduction to 1:1, apparently due to a combination of accelarated AV conduction and slowed flutter conduction. These include not only induction of significant bradycardia ( albeit usually short-lived ) — but also both ventricular and supraventricular tachyarrhythmias.

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Tachycardia Atrial Flutter Cardiomyopathy Atrial Fibrillation 52

Ken Grauer, MD

OCTOBER 4, 2024

To improve visualization — I've digitized the original ECG using PMcardio ) MY Thoughts on the ECG in Figure-1: This is a challenging tracing to interpret — because there is marked bradycardia with an irregular rhythm and a change in QRS morphology. Figure-1: The initial ECG in today's case. ( The QRS complex is wide ( ie, >0.10

Blog 101

Blog Bradycardia Arrhythmia Pacemaker 101

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

Previously healthy, taking no medication and exercising regularly. No anginal symptoms asymptomatic during physical exercise. Below in Figure-5 is a 10-minute continuous lead II recording on oral Flecainide, now showing sinus bradycardia without a single PVC! Below in Figure-1 is this patient's admission ECG. No PVCs are seen.

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Tachycardia Arrhythmia Ablation Atrial Flutter 72

Dr. Smith's ECG Blog

NOVEMBER 11, 2024

So, for example: atropine and exercise should both improve conduction in Mobitz I block, but make it worse in Mobitz II. Finally — Regardless of whether the 2:1 AV block is seen — there is marked bradycardia ( rate in the 40s ) , which of itself deserves investigation prior to approval for elective surgery.

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Arrhythmia Bradycardia Outpatient Pacemaker 71