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Written by Pendell Meyers A man in his 70s presented with history of pacemaker presented with shortness of breath with exertion and presyncope. Here is his triage ECG with minimal symptoms: What do you think? The ECG shows pacemaker failure with inability to capture or sense, with either underlying atrial fibrillation or junctional escape rhythm. The QRS shows LVH and there are diffuse ST-T abnormalities likely in part appropriate for the LVH, though memory T waves are also a consideration.
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We see an ECG with the limb leads and V1/V2. It shows a normal sinus rhythm with 1. degreeAV block and 1 conducted and 1 nonconducted PAC before the pause. There is a short pause in the middle of the ECG, how can this be explained? On closer inspection, a PAC can be seen in the ST segment/at the beginning of the T wave. This cannot be conducted due to the short coupling interval.
The White House finally unveiled its negotiated Medicare drug prices , bringing 38%-76% reductions to the first 10 drugs, while drawing mixed industry reactions. Medicare drug price negotiations are one of the highlighted results of 2022’s Inflation Reduction Act, allowing CMS to negotiate drug prices for the very first time. Between 2026 and 2029, CMS will select 60 targeted meds based on a range of factors (costs, usage, “single-source,” lack of generics, etc.) and negotiate their Medicare “ma
David Didlake EMT-P, RN, ACNP @DidlakeDW An adult male self-presented to the ED with palpitations and the following ECG. The patient was very uncomfortable, dyspneic, and displayed an SpO2 90% on RA. He denied any known history of CAD, but did report ASCVD risk factors to include HTN, HLD, and DM. Of interest, he specified that he awoke earlier that morning in his usual state of health, then developed chest discomfort, then developed palpitations.
David Didlake EMT-P, RN, ACNP @DidlakeDW An adult male self-presented to the ED with palpitations and the following ECG. The patient was very uncomfortable, dyspneic, and displayed an SpO2 90% on RA. He denied any known history of CAD, but did report ASCVD risk factors to include HTN, HLD, and DM. Of interest, he specified that he awoke earlier that morning in his usual state of health, then developed chest discomfort, then developed palpitations.
The impact of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on atrial fibrillation (AF) recurrence outcomes and adverse cardiovascular outcomes in heart failure (HF) patients after AF ablation is unknown.
A lack of standard Bachman Bundle(BB) capture criteria has affected the clinical impact of Bachmann Bundle Area Pacing(BBAP) in patients with inter-atrial block(IAB).
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare genetic heart disease associated with life-threatening ventricular arrhythmias. Diagnosis of ARVC is based on the 2010 Task Force Criteria (TFC), application of which often requires clinical expertise at specialized centers.
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