The Electrocardiogram at 100 Years: History and Future
Circulation
FEBRUARY 4, 2024
Circulation, Volume 149, Issue 6 , Page 411-413, February 6, 2024.
Abstract 4142589: GLP-1 receptor agonists slow the progression of subclinical cardiovascular risk as detected from 12-lead electrocardiograms
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4142589-A4142589, November 12, 2024. However, it is unclear whether early subclinical therapeutic changes can be detected from routine 12-lead electrocardiograms (ECGs).Methods:We
Abstract 4136784: Diagnostic significance and prognosis prediction of electrocardiogram plane QRS-T angle in patients with non-ST segment elevation acute coronary syndrome
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4136784-A4136784, November 12, 2024. Objective:For patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS), the diagnostic efficacy of traditional ECG is not sensitive and specific.
6 Cardiology Board Review Questions That Will Help You Pass the Boards
BoardVitals - Cardiovascular
JUNE 14, 2017
Question banks are a favorite exam preparation resource for Cardiologists that want to practice in the format of the exam.
Comparing Phenotypes for Acute and Long-Term Response to Atrial Fibrillation Ablation Using Machine Learning
Circulation: Arrhythmia and Electrophysiology
FEBRUARY 10, 2025
Circulation: Arrhythmia and Electrophysiology, Ahead of Print. BACKGROUND:It is difficult to identify patients with atrial fibrillation (AF) most likely to respond to ablation. We compared 6 machine learning models to predict acute and long-term end points after ablation and used Shapley explainability analysis to contrast phenotypes.
Abstract 4146680: Detecting Atrial and Ventricular Ectopy from the Apple Watch with an novel Deep Learning algorithm
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4146680-A4146680, November 12, 2024. Introduction:Personal electrocardiogram (ECG) devices have significant potential for monitoring abnormal heart rhythms outside clinical environments.
Bizarre (Hyperacute??) T-waves
Dr. Smith's ECG Blog
JANUARY 30, 2018
Electromechanical association: a subtle electrocardiogram artifact. Incredibly , this case was just published in Circulation on January 22, 2018 (thanks to Brooks Walsh for finding this!) link] Circulation. link] Circulation. Journal of Electrocardiology. 2012;45(1):15-17. doi:10.1016/j.jelectrocard.2010.12.162.
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Abstract 4145609: The Cardiac Conundrum of Cannabis: A Case of Junctional Bradycardia Triggered by Cannabis Use
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4145609-A4145609, November 12, 2024. Electrocardiogram (ECG) and telemetry revealed junctional bradycardia with heart rate in 30s and sinus pauses (5-7 seconds). Introduction:Cannabis has been increasingly used as a recreational drug. He was euvolemic on physical exam.
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Abstract 4140682: Clinical Case: Flipping the Script: Tackling CAD in Dextrocardia During Cardiac Catheterization
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4140682-A4140682, November 12, 2024. Electrocardiogram (ECG) showed a prominent S wave in the left-sided leads and a prominent R wave in the right-sided chest leads, suggesting dextrocardia. Patients usually have a normal life expectancy unless other structural heart diseases are present.
Abstract 4135360: Eosinophilic Myocarditis: An Atypical Presentation with a Labile Course: A Case Report
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4135360-A4135360, November 12, 2024. Electrocardiogram (EKG) was unremarkable. Case presentation:A 64-year-old man presented with one day of chest pain. Initial evaluation showed elevated cardiac enzymes (CE) and normal eosinophil count.
A woman in her 50s with chest pain and dyspnea
Dr. Smith's ECG Blog
MARCH 17, 2023
Electromechanical association: a subtle electrocardiogram artifact. This case was published in Circulation on January 22, 2018 (thanks to Brooks Walsh for finding this!) link] Circulation. Originally published January 22, 2018 Here is a case from Circulation year 2000 that was misdiagnosed as due to pancreatitis.
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Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs
Dr. Smith's ECG Blog
JANUARY 1, 2024
An initial electrocardiogram (ECG) is provided below. Cannon waves are associated with reduced RV compliance or elevated RV end-diastolic pressure ( Ali et al — Ann Noninvasic Electrocard 22:e12423, 2017 — and — Chen and Pel-Ying Pai — Circulation 119:e381, 2009 ). What do you think? What is the rhythm? The rate is 132 bpm.
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Rise of COVID's JN.1 Sub variant Cases in India in 2023
Wellnest
DECEMBER 31, 2023
1 poses an increased risk to public health compared to other circulating variants. Electrocardiograms (EKG or ECG): This diagnostic method effectively detects irregular heartbeats or arrhythmias by analyzing the electrical signals in the heart. According to doctors, there is no evidence, as per the WHO, that JN.1 Risk posed by JN.1
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Is OMI an ECG Diagnosis?
Dr. Smith's ECG Blog
APRIL 18, 2024
Circulation 2014 2. International evaluation of an artificial-intelligence- powered electrocardiogram model detecting acute coronary occlusion myocardial infarction. It is not yet available, but this is your way to get on the list. link] References 1. Amsterdam et al. Alencar et al. Int J Cardiol 2024 3. Lupu et al. McLaren and Smith.
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Precordial ST depression. What is the diagnosis?
Dr. Smith's ECG Blog
JANUARY 1, 2013
Circulation 2007;115(10):1306-24. In Wung’s study, 81% of patients with greater than or equal to 1mm STE in posterior leads also had other significant STE on the 12-lead ECG, and 96% had some ST deviation. Kligfield P, Gettes LS, Bailey JJ, et al. Taha B, Reddy S, Agarwal J, Khaw K. J Electrocardiol 1998;31 Suppl:178-9. Wung SF, Drew BJ.
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Four anterior STEMIs: acute and reperfused vs. won't reperfuse, subacute and reperfused vs. not reperfused
Dr. Smith's ECG Blog
OCTOBER 26, 2011
Circulation 1999;99(15):1972-7. Circulation 2000;101(2):125-30. Clinical value of 12-lead electrocardiogram after successful reperfusion therapy for acute myocardial infarction. Circulation 1998;97(23):2303-6. Gibson CM, Cannon CP, Murphy SA, et al. Shah A, Wagner GS, O'Connor CM, et al. Lancet 1997;350(9078):615-9.
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Are these Hyperacute T-waves?
Dr. Smith's ECG Blog
DECEMBER 5, 2022
Electromechanical association: a subtle electrocardiogram artifact. Incredibly , this case was just published in Circulation on January 22, 2018 (thanks to Brooks Walsh for finding this!) link] Circulation. link] Circulation. Journal of Electrocardiology. 2012;45(1):15-17. doi:10.1016/j.jelectrocard.2010.12.162.
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Why we need continuous 12-lead ST segment monitoring in Wellens' syndrome
Dr. Smith's ECG Blog
NOVEMBER 15, 2013
Circulation 1991;84:1454-1455. Early continuous ST segment monitoring in unstable angina: prognostic value additional to the clinical characteristics and the admission electrocardiogram. It shows that on a 7 day angiogram, only 58% of re-occlusions were symptomatic: Ohman EM, Califf RM, Topol EJ et al. Eur Heart J 2000;21:1464–1472.
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50-year old with chest pain, “no ischemic changes”
Dr. Smith's ECG Blog
DECEMBER 29, 2023
This again confirms there is a critical lesion in the first diagonal, which is either transiently open or is still occluded but being perfused through collateral circulation. International evaluation of an artificial intelligence-powered electrocardiogram model detecting acute coronary occlusion myocardial infarction.
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New Studies: AI Captures Electrocardiogram Patterns That Could Signal a Future Sudden Cardiac Arrest
DAIC
MARCH 1, 2024
In a study published in Communications Medicine , David Ouyang, MD, assistant professor of Cardiology and Medicine at Cedars-Sinai, along with Chugh and fellow investigators trained a deep learning algorithm to study patterns in electrocardiograms, also known as ECGs, which are recordings of the heart’s electrical activity.
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Right precordial ST depression in a patient with chest pain
Dr. Smith's ECG Blog
AUGUST 3, 2017
Circulation. Common pitfalls in the interpretation of electrocardiograms from patients with acute coronary syndromes with narrow QRS: a consensus report. O'Gara et al. Am J Cardiol 2001;87(8):970-4 5. Birnbaum Y, Baves de Luna A, Fiol M. J Electrocardiol. 2012 Sep;45(5):463-75. Boden WE, Kleiger RE, Gibson RS.
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Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment
MIBHS
OCTOBER 31, 2024
Electrocardiogram (ECG/EKG) An ECG records the electrical activity of the heart and can help detect abnormalities in the heart’s rhythm that might contribute to enlargement. Regular physical activity can strengthen the heart and improve circulation. Avoid smoking and limit alcohol intake.
A young lady with wide complex tachycardia. My first time actually making this diagnosis de novo in real life in the ED!
Dr. Smith's ECG Blog
JUNE 2, 2023
Usefulness of the Electrocardiogram in Establishing the Diagnosis and Prognosis of Arrhythmogenic Right Ventricular Cardiomyopathy Other References, from the above article: 1 FI Marcus Epsilon waves aid in the prognosis and risk stratification of patients with ARVC/D J Cardiovasc Electrophysiol, 26 (2015), pp. J Electrocardiol, 42 (2009), pp.
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96 Abstract 4141052: Rare Combo: An Unusual Case of a 54-year-old Filipino with Coronary Artery Fistula from Left Anterior Descending Artery to Main Pulmonary Artery and Acute Cerebellar Infarct: A Cardio – Cerebral Infarction Syndrome - Case Report
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4141052-A4141052, November 12, 2024. Laboratory tests showed markedly elevated troponin I levels (>50 ng/ml) and atrial fibrillation, along with inferior wall ST elevation on the electrocardiogram. The incidence of this dual infarction is currently unknown due to its rarity.
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Hypertropic Cardiomyopathy: A Board Review Question Explained By Video
BoardVitals - Cardiovascular
MAY 1, 2017
Explanation: Shown electrocardiogram suggests left ventricular hypertrophy. Shown electrocardiogram suggests left ventricular hypertrophy. Circulation. Start aspirin and Plavix Correct answer: (B) (B) Echocardiogram is indicated. Hypertrophic cardiomyopathy is one of them. Characteristic murmur should not be missed.
Abstract 4115652: Effect of the sodium-glucose co-transporter 2 inhibitor, Dapagliflozin, on ventricular repolarization electrocardiographic parameters: DAPA-ECG study
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4115652-A4115652, November 12, 2024.
Abstract 4134796: Safety of over 1000 consecutive, selected low risk patients with accelerated discharge from a chest pain unit with early generation cardiac troponin use, no cardiac functional or anatomic testing and no clinical risk scores
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4134796-A4134796, November 12, 2024. LR was based on normal examination, stable hemodynamics, normal electrocardiograms (ECG), and negative cardiac troponin I, without pre-discharge functional or anatomic cardiac testing or risk scores.
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Abstract 4120434: A Rare Case Of Localized Ventricular Tachycardia Due To Mitral Annular Disjunction And a Subvalvular Aneurysm
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4120434-A4120434, November 12, 2024. Electrocardiogram (ECG) showed sustained monomorphic VT at a rate of 160 bpm. Since its identification in 1981 its diagnosis has increased due to the advancements in cardiac imaging. cm SMA on the basal inferior and inferolateral walls.
How does Acute Total Left Main Coronary occlusion present on the ECG?
Dr. Smith's ECG Blog
AUGUST 9, 2019
Below are 6 anecdotal cases of true complete left main occlusion with no collateral circulation: 3 have STE in aVR 1 has no ST shift in aVR 2 have STD in aVR The ECG can have a variety of presentations in LM Occlusion. You'll see that there is collateral circulation from the RCA. Below is the angiogram. References 7.
Safety and Effectiveness of the High-Sensitivity Cardiac Troponin HEART Pathway in Patients With Possible Acute Coronary Syndrome
Circulation: Cardiovascular Quality & Outcomes
FEBRUARY 8, 2024
Circulation: Cardiovascular Quality and Outcomes, Ahead of Print. BACKGROUND:The HEART Pathway (History, Electrocardiogram, Age, Risk factors, Troponin) can be used with high-sensitivity cardiac troponin to risk stratify emergency department patients with possible acute coronary syndrome.
Abstract 4139536: Incidence of Severe QT Prolongation and the Assoicated Risk of Ventricular Arrhythmias and Sudden Cardiac Death in Patients Taking Antipsychotics or Antidepressants
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4139536-A4139536, November 12, 2024. Background:Limited data exist on the incidence of severe QT prolongation (SQTP) in patients using antipsychotics or antidepressants and the associated risk of ventricular arrhythmias (VA) and sudden cardiac death (SCD).Aims:This ms and +6.7 ± 36.1
Initial Reperfusion T-waves, Followed by Pseudonormalization. Diagnosis?
Dr. Smith's ECG Blog
MARCH 11, 2016
Circulation 1993; 88:896-904. Circulation 1995; 91:1659-1668. Circulation 1999; 74:1379-1389. Circulation 1990; 82:1147-1158. Prognostic significance of the initial electrocardiogram in patients with acute myocardial infarction. Methods: Oliva et al. (94) Lee KL, Woodlief LH, Topol EJ, et al. Methods: Lee et al.
A man in his 70s with weakness and syncope
Dr. Smith's ECG Blog
JULY 22, 2023
Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. Circulation, 117, 1890–1893. [3]: Heart Rhythm, 13(7): 1515-1520. [2]: 2]: Junttila MJ, Gonzalez M, Lizotte E, Benito B, Vernooy K, Sarkozy A, Huikuri HV, Brugada P, Brugada J, Brugada R. Brugada electrocardiographic pattern induced by fever.
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Hyperthermia and ST Elevation
Dr. Smith's ECG Blog
JANUARY 30, 2019
Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. Circulation, 117, 1890–1893. [3]: Heart Rhythm, 13(7): 1515-1520. [2]: 2]: Junttila MJ, Gonzalez M, Lizotte E, Benito B, Vernooy K, Sarkozy A, Huikuri HV, Brugada P, Brugada J, Brugada R. Brugada electrocardiographic pattern induced by fever.
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QT Correction Formulas Compared to The Rule of Thumb ("Half the RR")
Dr. Smith's ECG Blog
NOVEMBER 24, 2017
Essential Reading : Full text link: AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram, Part IV: The ST Segment, T and U Waves, and the QT Interval (full text link). Answer : you must treat the patient's underlying condition causing sinus tachycardia, and repeat the ECG at the lower heart rate.
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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.
Dr. Smith's ECG Blog
APRIL 8, 2015
Abnormal Electrocardiogram (ECG): Defined (San Fran syncope rule) as any new changes when compared to the last ECG or presence of non-sinus rhythm. Results : Electrocardiograms (99%), telemetry (95%), cardiac enzymes (95%), and head computed tomography (CT) (63%) were the most frequently obtained tests.
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