Hospital Ischemia Pacemaker 
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? Primary VT , and the VT with tachycardia is causing ischemia with chest discomfort (supply-demand mismatch/type 2 MI)? The last echocardiography 12 months ago showed HFmrEF.
Dr. Smith's ECG Blog
JULY 21, 2024
The patient was extubated on Day-3 of the hospital stay. The patient improved, and on Day-11 of the hospital stay — he was off inotropes and on a small dose of a ß-blocker. There is no definite evidence of acute ischemia. (ie, Some residual ischemia in the infarct border might still be present.
Dr. Smith's ECG Blog
JANUARY 1, 2024
The patient was promptly admitted to the hospital for further evaluation. Again, see Ken's discussion below) Discussion continued The absence of pace spikes suggests this is not a pacemaker/ICD-related rhythm in this patient with an ICD. An initial electrocardiogram (ECG) is provided below. What do you think? What is the rhythm?
Ken Grauer, MD
OCTOBER 27, 2023
My Immediate Impression — was that this elderly woman with a several week history of symptoms would most likely leave the hospital with a pacemaker. This suggests ischemia of uncertain duration. A permanent pacemaker was placed. PEARL # 2: Interpretation of the 12-lead ECG in Figure-1 is no easy task!
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.
Wellnest
DECEMBER 21, 2022
Patients use them to observe their heart activity by themselves when they are not in the hospital. Though their accuracy is not as high as a hospital ECG machine, they are very beneficial in detecting problems in any medical emergency and providing information about long-term heart activity.
EMS 12-Lead
JUNE 20, 2022
According to the EMS narrative, this patient initially refused hospital transport and advised that he would seek evaluation at a later time with his personal physician. Upon hospital arrival, the patient verbalized slight attenuation of pain. It’s important to stress the presence of a normal QRS (i.e., No serial ECG’s were recorded.
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