Dr. Smith's ECG Blog

JANUARY 2, 2025

See this post: How a pause can cause cardiac arrest 2. Because she has cardiomyopathy and ventricular dysrhythmias, the pacer included an Implanted Cardioverter-Defibrillator (ICD) Echo 6 days later after CRT: Normal estimated left ventricular ejection fraction. Even with tachycardia and a paced QRS duration of ~0.16

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Tachycardia Cardiomyopathy Blog Bradycardia 116

HeartRhythm

APRIL 30, 2024

We have recently reported that chronic kidney disease (CKD) is associated with higher likelihood of sudden cardiac arrest (SCA) presenting with non-shockable rhythms (NSR) (pulseless electrical activity/asystole), as opposed to shockable rhythms (ventricular fibrillation/pulseless ventricular tachycardia).

Cardiac Arrest 40

Cardiac Arrest Kidney Disease Defibrillator Tachycardia 40

Journal of Cardiovascular Electrophysiology

FEBRUARY 10, 2025

We sought to determine predictors of RV pacing in patients who did not have a pacing indication at the time of initial ICD implant. Conclusions This study provides insight into predictors of RV pacing in ICD recipients without pacing needs at baseline.

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Defibrillator Cardiac Arrest Tachycardia Hypertension 40

Dr. Smith's ECG Blog

APRIL 29, 2020

A 60-something woman presented after a witnessed cardiac arrest. She was never defibrillated. This is commonly found after epinephrine for cardiac arrest, but could have been pre-existing and a possible contributing factor to cardiac arrest. Cardiac cath showed minimal disease. She recovered.

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Cardiac Arrest Defibrillator Ischemia Tachycardia 52

Dr. Smith's ECG Blog

OCTOBER 10, 2022

It was reportedly a PEA arrest; there was no recorded V Fib and no defibrillation. He had multiple cardiac arrests with ROSC regained each time. This patient arrested shortly after hospital arrival. CPR was initiated immediately. Initial ROSC was obtained, during which this ECG was obtained: What do you think?

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Cardiac Arrest Chest Pain Embolism Pulmonary 52

Ken Grauer, MD

MARCH 23, 2023

She underwent cardiopulmonary resuscitation for VT/VFib — with ROSC ( R eturn O f S pontaneous C irculation ) following defibrillation and treatment with Epinephrine and Amiodarone. A series of cardiac arrhythmias were seen during the course of her resuscitation — including the interesting arrhythmia shown in the long lead II of Figure-1.

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Blog Tachycardia Arrhythmia Atrial Flutter 78

Dr. Smith's ECG Blog

SEPTEMBER 29, 2024

Although one may have all kinds of ischemic findings as a result of cardiac arrest (rather than cause of cardiac arrest), this degree of ST elevation and HATW is all but diagnostic of acute proximal LAD occlusion. This prompted cath lab activation. On arrival to the ED, this ECG was recorded: What do you think?

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Cardiac Arrest STEMI Ischemia SCAD 110

Dr. Smith's ECG Blog

OCTOBER 23, 2023

Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return of spontaneous circulation. She was successfully revived after several rounds of ACLS including defibrillation and amiodarone.

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Tachycardia Cardiac Arrest ICU Blog 131

Ken Grauer, MD

JUNE 14, 2024

The ECG in Figure-1 — was obtained from a middle-aged man who presented to the ED ( E mergency D epartment ) in cardiac arrest. The rhythm is regular — at a rate just over 100/minute = sinus tachycardia ( ie, the R-R interval is just under 3 large boxes in duration ). Should you activate the cath lab?

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Blog STEMI Cardiac Arrest Tachycardia 146

Frontiers in Cardiovascular Medicine

DECEMBER 18, 2023

Cardiac sarcoidosis (CS), a rare condition characterized by non-caseating granulomas, can manifest with symptoms such as atrioventricular block and ventricular tachycardia (VT), as well as mimic inherited cardiomyopathies. An endomyocardial biopsy (EMB) confirmed the diagnosis of cardiac sarcoidosis.

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Cardiomyopathy Cardiac Arrest Defibrillator Electrophysiology 69

Circulation

OCTOBER 27, 2023

BACKGROUND:In severely affected patients with catecholaminergic polymorphic ventricular tachycardia, beta-blockers are often insufficiently protective. The primary end point was AEs, defined as sudden cardiac death, sudden cardiac arrest, appropriate implantable cardioverter defibrillator shock, and arrhythmic syncope.

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Tachycardia Sudden Cardiac Death Defibrillator Cardiac Arrest 40

Dr. Smith's ECG Blog

JULY 21, 2024

This progressed to electrical storm , with incessant PolyMorphic Ventricular Tachycardia ( PMVT ) and recurrent episodes of Ventricular Fibrillation ( VFib ). He required multiple defibrillations within a period of a few hours. An ICD ( Implantable Cardioverter Defibrilator ) was placed prior to discharge. What do you think?

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Arrhythmia Cardiogenic Shock Bradycardia Defibrillator 131

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The arrhythmia spontaneously converted before defibrillation was achieved. This patient is actively dying from a left main coronary artery OMI and cardiac arrest from VT/VF or PEA is imminent! Complete LMCA occlusion is associated with clinical shock and/or cardiac arrest.

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Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest 129

Dr. Smith's ECG Blog

APRIL 8, 2016

At cath, he immediately had incessant Torsades de Pointes requiring defibrillation 7 times and requiring placement of a transvenous pacer for overdrive pacing at a rate of 80. See here for management of Polymorphic Ventricular Tachycardia , which includes Torsades. If cardiac arrest from hypokalemia is imminent (i.e.,

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STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 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. AI recognizing cardiac arrests in emergency calls. Recently, hospitals have failed to identify 25% of cases of cardiac arrest.

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Technology Cardiac Arrest Innovation Coronary Artery Disease 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2019

Is it ventricular tachycardia (VT) due to hyperK or is it a supraventricular rhythm with hyperK? Here are other posts on hyperK, large calcium doses for hyperK, and ventricular tachycardia in hyperK Weakness, prolonged PR interval, wide complex, ventricular tachycardia Very Wide and Very Fast, What is it? How would you treat?

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Cardiac Arrest Tachycardia Nursing Ultrasound 40

Dr. Smith's ECG Blog

SEPTEMBER 21, 2020

I was texted these ECGs by a recent residency graduate after they had all been recorded, along with the following clinical information: A 50-something with no cardiac history, but with h/o Diabetes, was doing physical work when he collapsed. MY Thoughts on ECG #1: The rhythm is sinus tachycardia at 105-110/minute.

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STEMI Hospital Blog Defibrillator 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

Otherwise vitals after intubation were only notable for tachycardia. An initial EKG was obtained: Computer read: sinus tachycardia, early acute anterior infarct. She was ventilated by bag-valve-mask by EMS on arrival and was quickly intubated with etomidate and succinylcholine. A rectal temperature was obtained which read 107.9

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Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

APRIL 6, 2018

Written by Pendell Meyers, with edits by Steve Smith Thanks to my attending Nic Thompson who superbly led this resuscitation We received a call that a middle aged male in cardiac arrest was 5 minutes out. There is a regular, wide complex, (mostly) monomorphic tachycardia. He was estimated to be in his 50s, with no known PMHx.

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Cardiac Arrest Tachycardia Defibrillator ICU 52

Dr. Smith's ECG Blog

DECEMBER 22, 2010

A 65 yo woman had felt ill for 36 hours, had seen her MD but without undergoing a cardiac evaluation. After epinephrine, atropine, and defibrillation x 2, there was a return of pulses. Exact rhythm during arrest is uncertain. She collapsed and 911 was called; she was found pulseless. These patients may survive.

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Cardiac Arrest Tachycardia STEMI Chest Pain 40

Dr. Smith's ECG Blog

DECEMBER 5, 2019

There is sinus tachycardia and also a large R-wave in aVR. Drug toxicity , especially diphenhydramine , which has sodium channel blocking effects, and also anticholinergic effects which may result in sinus tachycardia, hyperthermia, delirium, and dry skin. Her temperature was 106 degrees. As part of the workup, she underwent an ECG.

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Sudden Cardiac Death Heart Rhythm Article Tachycardia 52

Dr. Smith's ECG Blog

FEBRUARY 20, 2025

There was never ventricular fibrillation (VF) or ventricular tachycardia (VT), no shockable rhythm. The patient was unconscious BEFORE the cardiac arrest, at the same time that she had strong pulses. Therefore, cardiac arrest is NOT the etiology of the coma. There is sinus tachycardia at ~115/minute.

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STEMI Hemorrhage Cardiac Arrest Tachycardia 89