article thumbnail

Atrial arrhythmia and heart failure in congenital heart disease: a pas de deux with consequences

Heart BMJ

In adults with congenital heart disease (ACHD patients), atrial arrhythmias (AA) and heart failure (HF) are common. 1 Factors related to congenital heart disease, such as underlying anatomy, surgical repair technique and scars, can all be considered as AA substrates.

article thumbnail

Identifying etiologies of heart failure using non-contrast cardiac magnetic resonance imaging: cine imaging, T1 and T2 mapping, and texture analysis for T1 mapping

Frontiers in Cardiovascular Medicine

ObjectiveThe aim of this retrospective study was to evaluate the usefulness of non-contrast cardiac magnetic resonance imaging, including cine imaging, T1 and T2 mapping, and texture analysis for T1 mapping, for identifying etiologies of heart failure (HF).MethodsForty-seven MethodsForty-seven patients with HF were examined using a 1.5T

article thumbnail

Ventricular Fibrillation, ICD, LBBB, QRS of 210 ms, Positive Smith Modified Sgarbossa Criteria, and Pacemaker-Mediated Tachycardia

Dr. Smith's ECG Blog

Then I always look to see if the initial deflection of the QRS has a lot of voltage change per change in time (seen in tachycardias that are initiated from above the ventricle because the propagate through fast conducting purkinje fiber. Tachycardia exaggerates ST Elevation in LBBB and Paced rhythm 5. Pacemaker mediated tachycardia!

article thumbnail

Instructors' Collection ECG: Regular Really Wide QRS Tachycardia

ECG Guru

So, we can assume the patient was probably being treated for angina, heart failure, and hypertension. The ECG : The first impression is that is a regular WIDE COMPLEX TACHYCARDIA. It pays to take a moment to consider the possibility of REGULAR REALLY WIDE COMPLEX TACHYCARDIA (RRWCT) before making a treatment decision.

article thumbnail

A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

Dr. Smith's ECG Blog

She had a single chamber ICD/Pacemaker implanted several years prior due to ventricular tachycardia. Answer : The ECG above shows a regular wide complex tachycardia. The heart rate is about 130 bpm. The heart rate could be compatible with that of a 2:1 conducted atrial flutter. The ECG below was recorded. Is this: 1.

article thumbnail

A diagnostically challenging case of wide complex tachycardia

Heart BMJ

Clinical introduction A woman in her 60s with non-obstructive coronary artery disease, aortic valve replacement and aortic arch repair, chronic diastolic heart failure and paroxysmal atrial fibrillation (AF) and flutter (AFL), presented with 3 days of sustained palpitations that felt similar to prior episodes of AF/AFL.

article thumbnail

Torsade in a patient with left bundle branch block: is there a long QT? (And: Left Bundle Pacing).

Dr. Smith's ECG Blog

Permanent pacer placement Later, a biventricular pacer was placed for " Cardiac Resynchronization Therapy (CRT) " (This is indicated for patients with LBBB and QRS duration > 130 ms and heart failure and vastly improves heart failure). Even with tachycardia and a paced QRS duration of ~0.16 J Am Coll Cardiol.