Ken Grauer, MD

DECEMBER 12, 2024

If the patient is at least middle-aged , and especially if there is a history of underlying heart disease then statistical likelihood that a regular WCT without atrial activity will be VT increases to ~90%. ECG Blog #422 and Blog #425 Cases with Congenital Heart Disease in Adults.

Blog 82

Blog Tachycardia Heart Disease Congenital Heart Disease 82

ECG Guru

JULY 31, 2023

Broad complex tachycardia in a 78-year-old patient with coronary heart disease (CHD) and an old inferior myocardial infarction. Why is this a ventricular tachycardia (VT) and not a supraventricular tachycardia (SVT) with aberrant conduction? What other clues are there?

Tachycardia 52

Tachycardia Myocardial Infarction Heart Disease 52

HeartRhythm

OCTOBER 15, 2023

Ivabradine is an anti-arrhythmic agent that reduces the heart rate through inhibition of the pacemaker current of the sinoatrial node. It has been used to treat both inappropriate sinus tachycardia and sinus tachycardia related to heart failure in children and adults.

Congenital Heart Disease 40

Congenital Heart Disease Tachycardia Congenital Heart Disease 40

Dr. Smith's ECG Blog

OCTOBER 21, 2023

On the monitor patient had wide-complex tachycardia. Differential is ventricular tachycardia versus supraventricular tachycardia with aberrancy versus sinus tachycardia with a aberrancy. After the patient was stabilized with supportive care, the heart rate gradually slowed, confirming sinus tachycardia.

Tachycardia 138

Tachycardia Pulmonary Blood Pressure Blog 138

All About Cardiovascular System and Disorders

APRIL 23, 2024

Three or more ventricular beats in a row at a rate above 100 per minute is termed ventricular tachycardia. Ventricular tachycardia lasting more 30 seconds or requiring termination earlier due to hemodynamic compromise is called sustained ventricular tachycardia. Either case, the treatment is ablation of the right bundle.

Tachycardia 40

Tachycardia Ablation Myocardial Infarction Congenital 40

HeartRhythm

MARCH 2, 2025

Ventricular tachycardia (VT) with a 1:1 V-His relation can be seen in bundle branch reentry (BBR) or with passive retrograde activation from scar-related VT (SRR-VT) or reentry using left ventricular (LV) Purkinje fascicles (FPVT).

Tachycardia 40

Tachycardia Heart Disease 40

HeartRhythm

APRIL 30, 2024

In patients with scar-related left ventricular tachycardia (LV-VT), identifying the relevant substrate is crucial.

Tachycardia 40

Tachycardia Heart Disease 40

Dr. Smith's ECG Blog

MARCH 11, 2012

Here was his initial ECG: Regular Wide Complex Tachycardia. Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Approach to Wide Complex Tachycardia Unstable – Shock it 12-lead if at all possible --Unstable defined by : Chest Pain Shock Hypotension Very dyspneic Pulmonary Edema Stable Get a 12-lead ECG Sinus?

Tachycardia 52

Tachycardia Chest Pain Pulmonary Blood Pressure 52

HeartRhythm

APRIL 30, 2024

Idiopathic fascicular ventricular tachycardia is a unique form of Purkinje-related reentrant monomorphic VT that occurs in the absence of structural heart disease. Here, we present a case of recurrent ventricular tachycardia.

Tachycardia 40

Tachycardia Heart Disease 40

Heart BMJ

AUGUST 26, 2024

With this study, we aimed to estimate the prevalence of structural heart disease (SHD) and decipher the prognostic implications of CMR in selected patients presenting with significant VAs. A change in diagnosis after use of CMR ranged from 21% to 66% with a pooled average of 35% (29%–41%).

Arrhythmia 96

Arrhythmia Cardiomyopathy Heart Disease Tachycardia 96

Dr. Smith's ECG Blog

APRIL 15, 2020

Here is her ED ECG: Here is the ED physician's interpretation: IMPRESSION UNCERTAIN REGULAR RHYTHM, wide complex tachycardia, likely p-waves. LEFT BUNDLE BRANCH BLOCK [120+ ms QRS DURATION, 80+ ms Q/S IN V1/V2, 85+ ms R IN I/aVL/V5/V6] Comparison Summary: LBBB and tachycardia are new. This is clearly ventricular tachycardia.

Tachycardia 52

Tachycardia Nursing Heart Disease Dysrhythmia 52

Dr. Smith's ECG Blog

AUGUST 13, 2020

His previous echo one month prior shows the same thing: “consistent with old infarct in LAD vascular territory, with EF 45%” "I think there is something else causing his tachycardia which is exaggerating his EKG findings and mimicking an acute myocardial infarction." The patient spontaneously converted back to sinus tachycardia.

Tachycardia 52

Tachycardia AFIB Cardiogenic Shock Myocardial Infarction 52

HeartRhythm

APRIL 5, 2024

A 28-year-old man with recurrent palpitations and no structural heart disease presented with a documented wide QRS complex tachycardia (WCT). He had a history of slow pathway ablation for atrioventricular nodal reentrant tachycardia three months ago.

Tachycardia 40

Tachycardia Tricuspid Electrophysiology Document 40

Conquering CHD

JULY 11, 2023

Blood Pressure Many medications used to treat congenital heart disease can affect blood pressure levels. Heart Rate and Rhythm Some medications can slow down or speed up your heart rate. Your healthcare provider may recommend you wear a heart rate monitor or perform regular pulse checks to monitor your heart rate.

Congenital Heart Disease 52

Congenital Heart Disease Congenital Heart Disease Blood Clot 52

Science Daily - Heart Disease

APRIL 9, 2024

The study provides real-world evidence that a wide range of patients can safely and effectively use the experimental drug, called etripamil, to treat recurrent paroxysmal supraventricular tachycardia (PSVT) episodes at home, potentially sparing them the need for repeated hospital trips for more invasive treatments.

Heart Rhythm 119

Heart Rhythm Tachycardia Hospital 119

HeartRhythm

APRIL 30, 2024

Ventricular Tachycardia (VT) is an important cause of morbidity and mortality in structural heart Disease. Current literature is limited in direct comparison of VT in ischemic (ICM) compared to non-ischemic cardiomyopathy (NICM).

Tachycardia 40

Tachycardia Cardiomyopathy Heart Disease Ablation 40

HeartRhythm

APRIL 30, 2024

Multiple risk factors for arrhythmia recurrence after Ventricular Tachycardia (VT) ablation have been identified. However, the cumulative impact of these risk factors has not been evaluated, making it challenging to predict these risks in patients with multiple coexisting conditions.

Tachycardia 40

Tachycardia Ablation Risk Factors Heart Disease 40

Dr. Smith's ECG Blog

DECEMBER 16, 2018

Wide-complex tachycardia: VT or aberrant, or "other?" A wide-complex tachycardia in an older patient must immediately suggest ventricular tachycardia. Sinus tachycardia with aberrancy was unlikely as the rate was consistently 150 bpm, without spontaneous variation. And indeed the QRS morphology strongly supported VT (e.g.

Tachycardia 52

Tachycardia Atrial Flutter AFIB Atrial Fibrillation 52

Journal of Cardiovascular Electrophysiology

SEPTEMBER 23, 2024

Abstract Introduction Supraventricular tachycardia (SVT) is a common pediatric arrhythmia. Exclusion criteria were pre-excitation, ectopic atrial tachycardia, and hemodynamically significant heart disease. Methods and Results This is a multicenter retrospective cohort study from three academic children's hospitals.

Pediatrics 40

Pediatrics Tachycardia Academic Arrhythmia 40

Conquering CHD

JUNE 20, 2023

Congenital heart disease is a daunting diagnosis for any parent. We’ll cover common types of medications used to treat congenital heart disease, what parents should know about their use, and potential side effects to watch out for. Be sure to talk to your doctor if you have any questions or concerns.

Congenital Heart Disease 52

Congenital Heart Disease Congenital Heart Disease ACE Inhibitor 52

Dr. Smith's ECG Blog

DECEMBER 23, 2019

Initial ECG in the ED: Presenting ECG : Wide-complex tachycardia at a rate about 200. This is overwhelmingly likely to be ventricular tachycardia, even if only age and medical history are considered. Nevertheless, the widths of both the QRS complex and the RS duration are similar in both the old ECG and the tachycardia.

Tachycardia 52

Tachycardia Atrial Flutter Cardiomyopathy Atrial Fibrillation 52

HeartRhythm

APRIL 30, 2024

Short-long-short (S-L-S) electrocardiographic cycle length patterns are associated with incidence of ventricular tachycardia (VT) and ventricular fibrillation (VF). It is also recognised that pacemakers can facilitate these cycle length sequences, and that the observation of these sequences can predict future VT/VF events.

Coronary Artery Bypass Graft 40

Coronary Artery Bypass Graft Tachycardia Defibrillator Pacemaker 40

HeartRhythm

APRIL 30, 2024

Body surface microvolt QRS alternans has been shown to predict ventricular tachycardia (VT) in patients with structural heart disease, yet its relationship with the VT circuit is undefined.

Tachycardia 40

Tachycardia Cardiomyopathy Heart Disease 40

Frontiers in Cardiovascular Medicine

JANUARY 10, 2024

For patients with cardiovascular disease, using the antidepressant escitalopram may lead to unexpected adverse events. In an 82-year-old female patient with cardiac dysfunction using digoxin, tachycardia (average heart rate of 93 beats/min) was demonstrated by electrocardiogram (ECG).

Bradycardia 64

Bradycardia Heart Disease Electrocardiogram Heart Rhythm 64

HeartRhythm

APRIL 30, 2024

Over the past decade, the care of athletes with a genetic heart disease (GHD) has been changing with growing support for their return-to-play (RTP). Nevertheless, guidelines surrounding RTP for athletes who are genotype positive but phenotype negative (G+/P-) remain variable and their management challenging.

Heart Disease 40

Heart Disease Cardiomyopathy Tachycardia Outcomes 40

Journal of Cardiovascular Electrophysiology

JANUARY 13, 2025

Mutations in RyR2 and its dysfunction are implicated in various congenital heart diseases (CHDs).

Congenital Heart Disease 40

Congenital Heart Disease Electrophysiology Congenital Heart Disease 40

Circulation: Arrhythmia and Electrophysiology

JUNE 5, 2024

BACKGROUND:Epicardial approach in ventricular tachycardia (VT) ablation is still regarded as a second-step strategy, due to the risk of complications. Circulation: Arrhythmia and Electrophysiology, Ahead of Print.

Ablation 40

Ablation Tachycardia Heart Disease Cardiomyopathy 40

HeartRhythm

APRIL 30, 2024

Ventricular tachycardia (VT) ablations in patients with structural heart disease remain challenging procedures with non-trivial rates of acute and short-term complications and VT recurrences, due, in part, to the inherent limitations on size and depth of ventricular lesions produced by existing RF and focal cryo catheters.

Heart Disease 40

Heart Disease Tachycardia Technology Ablation 40

All About Cardiovascular System and Disorders

FEBRUARY 14, 2024

All these features together in a cyanotic congenital heart disease is characteristic of tricuspid atresia. Ebstein’s anomaly may be associated with right sided accessory pathway in ventricular pre-excitation, that is WPW syndrome, with or without atrioventricular re-entrant tachycardia.

Congenital Heart Disease 52

Congenital Heart Disease Congenital Heart Disease VSD 52

Ken Grauer, MD

MARCH 1, 2024

C linical I MPRESSION: I would interpret ECG #1 as suggestive of near ventricular standstill — with underlying atrial tachycardia, extended pauses, and no reliable ventricular escape focus. We have no idea how long the pause was before the 1st beat in ECG #1 was recorded. This is often a pre-lethal rhythm.

Blog 197

Blog Pacemaker Chest Pain Heart Disease 197

Dr. Smith's ECG Blog

JUNE 1, 2020

Monomorphic VT may occur in patients with or without underlying structural heart disease. The occurrence of monomorphic VT in a patient without underlying structural heart disease ( and without QT prolongation or metabolic/electrolyte abnormalities ) — is known as Idiopathic VT.

Tachycardia 52

Tachycardia AFIB Blog Heart Disease 52

HeartRhythm

APRIL 30, 2024

Different imaging modalities have been used to identify and target the abnormal myocardial substrate harboring ventricular tachycardia (VT).

Heart Disease 40

Heart Disease Tachycardia Ablation 40

Dr. Smith's ECG Blog

OCTOBER 23, 2023

An Initial ECG was performed: Initial ECG: Sinus tachycardia with prolonged QT interval (QTc of 534 ms by Bazett). She was admitted to the ICU where subsequent ECGs were performed: ECG at 12 hours QTc prolongation, resolution of T wave alternans ECG at 24 hours Sinus tachycardia with normalized QTc interval. No ischemic ST changes.

Tachycardia 130

Tachycardia Cardiac Arrest ICU Blog 130

Dr. Smith's ECG Blog

JUNE 23, 2023

A 50-something male with unspecified history of cardiomyopathy presented in diabetic ketoacidosis (without significant hyperkalemia) with a wide complex tachycardia and hypotension. Analysis: there is a wide complex tachycardia. This was the interpretation I put into the system: WIDE COMPLEX TACHYCARDIA. It is regular.

Tachycardia 52

Tachycardia Cardiomyopathy Arrhythmia Diabetes 52

HeartRhythm

OCTOBER 21, 2024

Different imaging modalities have been used to image and display scar tissue accelerating substrate identification and streamlining mapping and ablation of ventricular tachycardias (VTs). Ventricular arrhythmias typically originate from scar tissue.

Ablation 40

Ablation Myocardial Infarction Heart Disease Tachycardia 40

Ken Grauer, MD

JUNE 26, 2023

The ECG in Figure-1 was obtained from a young man with a history of rheumatic heart disease — who presented with “palpitations”. Statistically, in an unselected adult population — VT is much more common than an SVT rhythm , especially in a patient such as the one in today’s case who has underlying heart disease.

Blog 146

Blog Heart Disease Tachycardia Ablation 146

HeartRhythm

MARCH 12, 2024

Her clinical tachycardia was easily inducible and had a cycle length (TCL) of 340 ms. A 37-year-old woman with biventricular repair for pulmonary atresia and an intact ventricular septum was referred for an electrophysiological study in the context of recurrent atrial arrhythmias with multiple electrical cardioversions.

Congenital Heart Disease 40

Congenital Heart Disease Congenital Heart Disease Electrophysiology 40