Heart Failure Ischemia Pacemaker 
Dr. Smith's ECG Blog
JANUARY 2, 2025
Place temporary pacemaker 3. It should be kept in mind that on occasions, beta-one agonist can result in increased ventricular ectopy e.g., in severe myocardial ischemia (by increasing myocardial demand), or sometimes with congenital long-QT syndrome. See this post: How a pause can cause cardiac arrest 2.
Dr. Smith's ECG Blog
JANUARY 9, 2024
She had a single chamber ICD/Pacemaker implanted several years prior due to ventricular tachycardia. Are you confident there is no ischemia? The heart rate is about 130 bpm. The heart rate could be compatible with that of a 2:1 conducted atrial flutter. The last echocardiography 12 months ago showed HFmrEF.
Dr. Smith's ECG Blog
JANUARY 1, 2024
His medical history includes hypertension, a decade-long battle with diabetes, ischemic heart disease, a coronary bypass graft surgery ten years ago, a diagnosis of congestive heart failure for the last five years, and a prior ICD implantation five years ago. Thus VT is very probable.
Dr. Smith's ECG Blog
MARCH 22, 2024
The fact that R waves 2 through 6 are junctional does make ischemia more difficult to interpret -- but not impossible. The Queen of Hearts does not care about rhythm analysis, she simply looks at the ECG and decides whether it represents OMI or not. second that sinus-conducted beats #1,7,8 tell us is needed for normal AV conduction ).
Dr. Smith's ECG Blog
JANUARY 22, 2020
There was no evidence of ischemia. She had a permanent pacemaker implanted. After pacer AND conversion to sinus rhythm: Computer diagnosis: IMPRESSION ELECTRONIC VENTRICULAR PACEMAKER ABNORMAL RHYTHM ECG What is missing from this interpretation? We are not told how ischemia has been ruled out in this case. Hyperkalemia.
EMS 12-Lead
JUNE 1, 2022
Such findings would normally suggest primary ischemia with concomitant surveillance of coronary occlusion, but these ST/T changes might very well be secondary to the Escape mechanism at hand. The patient care narrative states no further changes in heart rate with persistent LBBB morphology. European Heart Journal, 28 , 2449-2455. [7]
DAIC
MARCH 25, 2024
Rapid Fire Challenging Structural Heart Imaging Cases with Heart Team Panel; Follow-up of Pacemakers and ICDS for the Non-electrophysiologist; The Real Reasons Your Patient with Heart Failure was Readmitted: Noncardiac Comorbidities, Geriatric Syndromes and Social Determinants of Health; and Death by a Thousand Cuts!
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