Dr. Smith's ECG Blog

OCTOBER 28, 2013

She was found to be in ventricular fibrillation and was defibrillated 8 times without a single, even transient, conversion out of fibrillation. She was immediately intubated during continued compressions, then underwent a 9th defibrillation, which resulted in an organized rhythm at 42 minutes after initial arrest. It was stented.

Cardiac Arrest 52

Cardiac Arrest Ischemia Defibrillator Electrocardiogram 52

AMS Cardiology

SEPTEMBER 30, 2024

We offer a wide range of diagnostic and treatment services including: Coronary artery bypass surgery Angioplasty and stenting Heart valve surgery Pacemaker and defibrillator implantation Cardiac rehabilitation We believe every patient deserves personalized care.

Heart Disease 52

Heart Disease Blood Pressure Cholesterol Exercise 52

Dr. Smith's ECG Blog

OCTOBER 3, 2017

After the second defibrillation the patient had an organized rhythm: Bradycardic escape/agonal rhythm, with large ST deviations. The patient was taken back to the cath lab, where 100% proximal in-stent rethrombosis was found and treated. It should have been shocked at least 10 seconds ago. This is diagnostic of re-occlusion.

Chest Pain 52

Chest Pain STEMI Defibrillator Blog 52

EMS 12-Lead

MARCH 19, 2023

He denied any known medical history, specifically: coronary artery disease, hypertension, dyslipidemia, diabetes, heart failure, myocardial infarction, or any prior PCI/stent. Despite immediate chest compressions, and multiple rounds of defibrillation, he could not be resuscitated. No appreciable skin pallor.

Myocardial Infarction 52

Myocardial Infarction STEMI Coronary Angiogram Coronary Artery Disease 52

Dr. Smith's ECG Blog

JUNE 19, 2023

During angiogram in the cath lab, the patient suffered two episodes of ventricular fibrillation for which he was successfully defibrillated. Two stents were placed with resultant TIMI 3 flow.

Chest Pain 52

Chest Pain STEMI Cardiogenic Shock Bradycardia 52

Dr. Smith's ECG Blog

SEPTEMBER 20, 2018

He was defibrillated immediately and had return of normal mental status. They found an acute lesion of the LAD at the site of the prior stents, including 70% proximal LAD lesion and 95% mid-LAD stenosis with TIMI 3 flow at the time of cath. The LAD lesion was acute and required 3 stents to restore flow.

Chest Pain 52

Chest Pain STEMI Cardiac Arrest Aneurysm 52

Dr. Smith's ECG Blog

AUGUST 17, 2019

100% proximal LAD successfully stented. Defibrillated out of v fib in the cath lab. "Bedside echo revealed anteroseptal wall motion abnormality at which point I activated a code STEMI. Cardiology agreed to take the pt to the lab but thought it would likely be negative. Initial TnI was negative. "I

Chest Pain 52

Chest Pain STEMI Blog Ischemia 52

Dr. Sanjay Gupta

MARCH 6, 2022

Interventions that may prolong life include implantation of a defibrillator. Patients with a very weak hearts may be prone to life threatening heart rhythm disturbances and therefore a defibrillator within the chest can detect this and deliver a life-saving shock there and then and thereby prolong life.

Chronic Disease 40

Chronic Disease Quality of Life Heart Failure Nursing 40

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. This was stented. The patient was intubated, given antiplatelet and antithrombotic therapy, 10 mEq of KCl IV was started, and sent to the cath lab.

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52

Wellnest

JULY 19, 2023

These issues can only be addressed in an ICCU (Intensive Coronary Care Unit) setting, where temporary pacemakers and defibrillators are available. Then angioplasty is performed, and a medical device called a stent (metallic scaffold) is deployed in the artery to open the blood flow. This is known as a pharmaco-invasive approach.

Heart Attack 52

Heart Attack Heart attacks Blood Pressure Myocardial Infarction 52

Dr. Smith's ECG Blog

MARCH 8, 2025

After stent deployment, we often see improvement in the ST-T within seconds or minutes. Here is the final angiogram following placement of a stent in the ostial RCA. 2:04 PM, post stent deployment You can see that even after complete restoration of flow, the ECG still looks terrible, V most of all. SanzRuiz, R., Solis, J., &

Cardiomyopathy 75

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia 75

Dr. Smith's ECG Blog

MARCH 25, 2025

In this case, you should get a second defibrillator and perform double sequential external defibrillation (DSED). Simply attach a second defibrillator as shown in the diagram below and deliver max shocks from both devices simultaneously. In the second case, the patient never converted meaning the shock did not do its job at all.

Chest Pain 63

Chest Pain Ischemia Plaque Stents 63

Dr. Smith's ECG Blog

DECEMBER 27, 2024

Submitted anonymously, written by Willy Frick A man in his 70s with a history of remote MI (details unavailable) and prior stent placement presented to cardiology clinic for routine follow up. He complained of days to weeks of palpitations and dyspnea. His clinic ECG is shown. What do you think? For How Long can a Patient remain in Stable VT?

Tachycardia 121

Tachycardia Stents Stent Arrhythmia 121

Dr. Smith's ECG Blog

FEBRUARY 2, 2025

Defibrillation was performed, and ROSC was achieved. Total proximal LAD occlusion was found and stented at angiography soon after the ECG above. Unfortunately, the ECG was interpreted as no significant change from prior , "no STEMI"!! He was sent back to the waiting room, where he suffered a VF arrest.

Cardiac Arrest 86

Cardiac Arrest STEMI Blog Ischemia 86

Dr. Smith's ECG Blog

NOVEMBER 29, 2024

The report describes heavy plaque in the proximal RCA by IVUS, but no lesions in the previously occluded RPL branch and no stent was deployed. Throughout this process, the patient had repeated VF and was defibrillated 8 times. It is consistent with an inferior LV aneurysm. Prolonged thrombectomy effort was unsuccessful.

Chest Pain 66

Chest Pain Hospital Anatomy Aneurysm 66