Frontiers in Cardiovascular Medicine

OCTOBER 9, 2024

The primary outcome was ventricular arrhythmias, the secondary outcomes were bradycardia and atrial fibrillation (AF).ResultsOur Perioperative or postoperative use of DEX reduced the incidence of in-hospital ventricular arrhythmias [Odds Ratio (OR) 0.14, 95% Confidence Interval (CI) 0.03–0.66], 8.17) compared with propofol.

Arrhythmia 52

Arrhythmia Bradycardia Atrial Fibrillation Hospital 52

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. No patients underwent prophylactic TPW insertion.

Bradycardia 72

Bradycardia Diabetes Hospital 72

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 100

Chest Pain STEMI Bradycardia Stent 100

HeartRhythm

APRIL 30, 2024

The implantation of leadless pacemakers has grown in recent years for the management of bradycardias. There are no randomized controlled trials to evaluate outcomes for single-chamber transvenous (TV), dual-chamber TV, and leadless pacemakers.

Pacemaker 40

Pacemaker Bradycardia Inpatient Hospital 40

Dr. Smith's ECG Blog

OCTOBER 24, 2024

This ECG shows sinus bradycardia with massively long QT (or QU?) Especially when present in the setting of bradycardia and syncopal episodes, this is very worrisome for high risk of lethal dysrhythmias including polymorphic ventricular fibrillation (termed Torsades when in the setting of long QT). interval, at over 600 msec.

Dysrhythmia 110

Dysrhythmia Atrial Fibrillation Bradycardia Ablation 110

Dr. Smith's ECG Blog

JULY 21, 2024

The patient was extubated on Day-3 of the hospital stay. The patient improved, and on Day-11 of the hospital stay — he was off inotropes and on a small dose of a ß-blocker. There was no evidence bradycardia leading up to the runs of PMVT ( as tends to occur with Torsades ).

Arrhythmia 131

Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

EMS 12-Lead

SEPTEMBER 8, 2024

He was hospitalized one week prior to EMS arrival for a seizure with no other recent illnesses or injuries. Bradycardia with “borderline hypotension” as described by the paramedics (BP 104/40) with 3-lead ECG as seen in Figure 1 were found. BVM was continued via NPA and the patient transported to the closest hospital.

Blood Pressure 92

Blood Pressure Bradycardia Hospital Electrophysiology 92

Dr. Smith's ECG Blog

OCTOBER 18, 2023

A few days into her hospital stay she developed chest discomfort and the following ECG was recorded. The ECG below was on file and was taken a few days earlier, on the day of admission to the hospital. She is healthy with no known cardiac disease. She was admitted to the neurology department due to headache and vomiting.

Cardiac Arrest 122

Cardiac Arrest Tachycardia Cardiomyopathy Bradycardia 122

HeartRhythm

APRIL 30, 2024

Introduction: Leadless pacemakers (LP) are increasingly utilized in pts with bradycardia and may be associated with better outcomes compared to right ventricular pacing (RVP). Conduction system pacing (CSP) with HBP or LBBAP have been associated with reduction in death or heart failure hospitalization (HFH).

Pacemaker 40

Pacemaker Bradycardia Outcomes Heart Failure 40

HeartRhythm

MARCH 7, 2024

A newborn male was delivered via cesarean section at term due to acute fetal distress and fetal bradycardia, necessitating emergency pacemaker implantation. During hospitalization, the infant experienced multiple seizures and episodes of hypoglycemia.

Bradycardia 40

Bradycardia Electrocardiogram Pacemaker Hospital 40

Ken Grauer, MD

SEPTEMBER 15, 2024

For full discussion of the case — CLICK HERE — ECG Rhythm Overview: A 12-year-old boy was admitted to our hospital with severe myocardial dysfunction and chaotic rhythm with tachy- and bradycardic arrhythmias. ECG #2: Figure-2: ECG #2 is from the 4th hospital day. Hope this helps — :) ECG-3 — I see sinus bradycardia and arrhythmia.

Arrhythmia 78

Arrhythmia Bradycardia Heart Failure Pacemaker 78

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Between 81-95% of life-threatening ventricular dysrhythmias and acute cardiac failure occur within 24-48 hours of hospitalization. Other Arrhythmias ( PACs, PVCs, AFib, Bradycardia and AV conduction disorders — potentially lethal VT/VFib ). RBBB in blunt chest trauma seems to be indicative of several RV injury.

Tachycardia 115

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia 115

Journal of Cardiovascular Electrophysiology

APRIL 10, 2025

Methods The TriNetX database (Jan 2015June 2023) was queried to include adults receiving their first single-chamber ventricular pacemaker for heart block, bradycardia, sick sinus syndrome, atrial fibrillation, or syncope, excluding those with prior pacemakers, heart failure or enrolled for research settings. were males, with mean ages of 74.9

Pacemaker 40

Pacemaker Heart Failure Atrial Fibrillation Bradycardia 40

Dr. Smith's ECG Blog

JANUARY 13, 2024

The patient and his wife suspected this was due to withholding of his midodrine and fludrocortisone during the hospitalization for his procedure. A few days after that, he was hospitalized for an unrelated reason, an abdominal infection. On the day of hospitalization, he had a CT scan. The case continues.

Pacemaker 110

Pacemaker Bicuspid/Mitral Blood Pressure Bradycardia 110

Dr. Smith's ECG Blog

OCTOBER 25, 2023

The patient was admitted to the ICU for close monitoring and electrolyte repletion and had an uneventful hospital course. Syncope and Bradycardia Syncope in a 20-something woman Long QT: Do not trust the computerized QT interval when the QT is long An Alcoholic Patient with Syncope Cardiac Arrest. Is it STEMI? What is going on here?

Chest Pain 124

Chest Pain Ischemia Cardiac Arrest Blog 124

Open Heart

JULY 28, 2023

Secondary endpoints are 30 s or more persistent supraventricular tachycardia and ventricular tachycardia, 3 s or more persistent pause, bradycardia with 40 beats per minutes or lower heart rate, AF burden, all-cause death, cardiovascular death, hospital readmission due to exacerbation of HF, acute coronary syndrome, ischaemic or haemorrhagic stroke, (..)

Atrial Fibrillation 40

Atrial Fibrillation Arrhythmia Heart Failure Tachycardia 40

Dr. Smith's ECG Blog

OCTOBER 20, 2024

He was later transferred back to his local hospital neurologically intact and without serious sequela. See this case and this case for more examples of ACS involving the LMCA Learning points: LMCA occlusion carries a poor prognosis, most patients do not make it to the hospital. Long term follow up is not available.

Cardiogenic Shock 128

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 128

European Journal of Heart Failure

NOVEMBER 22, 2023

Lower panels: Kaplan–Meier curves for 1-year all-cause death or HF hospitalization according to beta-blockers, ACEi/ARB/ARNI and MRA prescription and dosing. Treatment with BB and ACEi/ARB/ARNI were associated with a lower risk of death or HF hospitalizations (adjusted hazard ratio [HR] 0.63, 95% confidence interval [CI] 0.48–0.84,

Heart Failure 40

Heart Failure Bradycardia Hospital Outcomes 40

Dr. Smith's ECG Blog

NOVEMBER 10, 2017

This was sent to me by a former resident from a community hospital: A middle-aged woman complained of chest pain and was seen in triage. The computer interpreted the ECG (GE Marquette 12 SL) as: "Sinus Bradycardia. Here it is: Computer interpretation: "Sinus bradycardia. She had a ECG recorded. Normal ECG."

Chest Pain 52

Chest Pain Bradycardia Technology Electrocardiogram 52

Dr. Smith's ECG Blog

NOVEMBER 24, 2017

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.

Bradycardia 52

Bradycardia Article Atrial Fibrillation Chest Pain 52

Ken Grauer, MD

OCTOBER 27, 2023

That said — obvious findings include: i ) Marked bradycardia! — My Immediate Impression — was that this elderly woman with a several week history of symptoms would most likely leave the hospital with a pacemaker. The rhythm in Figure-1 is complex — and defies precise interpretation without careful study. be regular! —

Blog 101

Blog Pacemaker Bradycardia Arrhythmia 101

Ken Grauer, MD

AUGUST 26, 2023

I see the following: The rhythm is sinus bradycardia at ~55-60/minute. About 20 minutes later ( on the way to the hospital ) — the patient's CP resolved, and ECG #1 was recorded. That said, even without more history and without a prior ECG for comparison — the initial ECG in Figure-1 clearly is of concern!

Blog 145

Blog Chest Pain STEMI Ischemia 145

Circulation

NOVEMBER 11, 2024

The relationship between low RHR and CI has yet to be described.Purpose:We hypothesize that resting sinus bradycardia (low RHR) could be a predictor of chronotropic incompetence and reduced exercise capacity.Methods:The derivation cohort consists of 201 patients with normal Bruce protocol treadmill stress echocardiogram.

Exercise 40

Exercise Chest Pain Myocardial Infarction Bradycardia 40

Dr. Smith's ECG Blog

MAY 5, 2022

A few days later an ECG was repeated which showed normal sinus rhythm with no further hyperkalemia findings: After a 3-week hospitalization for acute renal failure, hyperkalemia, and compartment syndrome, the patient was discharged to acute rehab. He went emergently to the OR for fasciotomy due to compartment syndrome. With a twist.

Chest Pain 52

Chest Pain Bradycardia Cardiac Arrest STEMI 52

Wellnest

JUNE 19, 2023

Similarly, you may use our , app to adjust the paper speed along with amplification to read the slightest changes, especially for conditions like tachycardia and bradycardia. Recently, hospitals have failed to identify 25% of cases of cardiac arrest. The profound learning provides phenotyping of cardiovascular health in seconds.

Technology 52

Technology Cardiac Arrest Innovation Coronary Artery Disease 52

Wellnest

DECEMBER 21, 2022

Patients use them to observe their heart activity by themselves when they are not in the hospital. Though their accuracy is not as high as a hospital ECG machine, they are very beneficial in detecting problems in any medical emergency and providing information about long-term heart activity.

Cardiac Arrest 52

Cardiac Arrest Heart Attack Heart attacks Atrial Fibrillation 52

Dr. Smith's ECG Blog

APRIL 8, 2016

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. The corrected QT interval is extremely long, about 500 ms. However, the mean level (2.50.4

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Dr. Smith's ECG Blog

JANUARY 22, 2020

There are 3 etiologies I always think of with bradycardia and AV block: 1. While the diagnosis of SSS may become readily apparent early on in many patients clear indication for pacing usually does not become established until there is profound, symptomatic bradycardia usually requiring pauses of at least 3.0 Hyperkalemia.

Pulmonary 52

Pulmonary AFIB Atrial Fibrillation Pacemaker 52

Dr. Smith's ECG Blog

OCTOBER 15, 2024

Patient 1 remained in the hospital overnight. He had multiple episodes of bradycardia and nonsustained ventricular tachycardia. Angiography revealed a 30% nonobstructive stenosis of the mid LAD. Serial high sensitivity troponin T (URL 15 ng/L) values were negative and stagnant. He went to the cath lab at 0900 the next morning.

Chest Pain 116

Chest Pain STEMI Echocardiogram Stent 116

EMS 12-Lead

JUNE 1, 2022

Hospital transport was unremarkable. 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. The patient advised overall improvement with complete resolution of symptoms.

Heart Failure 52

Heart Failure Myocardial Infarction Bradycardia Chest Pain 52

EMS 12-Lead

MARCH 19, 2023

Could there have been a different outcome if the crews immediately recognized OMI – versus a shortened PR-interval – and commenced with pre-hospital Cath Lab activation? This was all very alarming because his baseline routine, otherwise, is unencumbered as he reports a usually high exertional tolerance.

Myocardial Infarction 52

Myocardial Infarction STEMI Coronary Angiogram Coronary Artery Disease 52

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. Because of its potential for invoking uneeded cardiac catheterization or hospital admission — it is worth periodically reviewing this ECG pattern.

Blog 52

Blog Bradycardia Ischemia Exercise 52

Dr. Smith's ECG Blog

NOVEMBER 3, 2017

Case 4 Transient STEMI, serial ECGs prehospital to hospital, all troponins negative (less than 0.04 Patient presentation is important This was a 60-something with acute chest pain: There is sinus bradycardia at a rate of 44. In case you were wondering about the T-waves and bradycardia, the K was normal. Why bradycardia?

Chest Pain 52

Chest Pain STEMI Bradycardia Stenosis 52

Dr. Smith's ECG Blog

MAY 26, 2023

C HALLENGE : Take another LOOK at the first 2 tracings shown in today's case. For clarity in Figure-1 — I've reproduced and put these first 2 ECGs together. Laddergram Illustration: The mechanism of AV block in ECG #2 is complex.

Cardiogenic Shock 98

Cardiogenic Shock Arrhythmia Blog Education 98

Dr. Smith's ECG Blog

JULY 24, 2018

Written by Pendell Meyers We received a call from an outside hospital asking to transfer a "traumatic post arrest" patient. Hyperkalemia findings include the classic peaked T-waves, as well as the deadly B's of hyperkalemia: Broad (wide QRS), Brady (bradycardia), Blocks (AV blocks), and Bizarre.

Cardiac Arrest 52

Cardiac Arrest Tachycardia Chest Pain ICU 52

Dr. Smith's ECG Blog

OCTOBER 11, 2020

We have countless cases of missed posterior MI on this blog, including these: Interventionalist at the Receiving Hospital: "No STEMI, no cath. I do not accept the transfer." "It It isn't a STEMI," so cath lab refusal (again). Were they right?

Chest Pain 52

Chest Pain STEMI Blog Tachycardia 52

Dr. Smith's ECG Blog

JANUARY 23, 2023

Triage physician interpretation: -sinus bradycardia -lateral ST depressions While there are lateral ST depressions (V5, V6) the deepest ST depressions are in V4. The patient was started on dual antiplatelet therapy and discharged from the hospital on day 3 without further event. Triage EKG: What do you think?

Chest Pain 52

Chest Pain Blog Stenosis Myocardial Infarction 52