Dr. Smith's ECG Blog

MARCH 28, 2024

male with pertinent past medical history including Atrial fibrillation, atrial flutter, cardiomyopathy, Pulmonary Embolism, and hypertension presented to the Emergency Department via ambulance for respiratory distress and tachycardia. Description : Regular Wide Complex Tachycardia at a rate of about 160. SVT with aberrancy?

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Tachycardia Atrial Fibrillation AFIB Atrial Flutter 129

DAIC

JUNE 19, 2024

Cingolani, director of Cardiogenetics and Preclinical Research in the Department of Cardiology in the Smidt Heart Institute at Cedars-Sinai, is exploring new ways to help patients with ventricular tachycardia (VT), a recurring, abnormally fast and irregular heartbeat that starts in the lower chambers, or ventricles, of the heart.

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Tachycardia Cardiac Arrest Ablation Research 128

ECG Guru

MARCH 6, 2024

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. So, we can assume the patient was probably being treated for angina, heart failure, and hypertension.

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Tachycardia ACE Inhibitor Angina Heart Failure 98

Dr. Smith's ECG Blog

JUNE 28, 2023

A prehospital 12-lead was recorded: There is a regular wide complex tachycardia. The computer diagnosed this as Ventricular Tachycardia. There is a wide complex regular tachycardia at a rate of 226. Toothache, incidental Wide Complex Tachycardia Could it be fascicular VT or Bundle Branch VT ( i.e., idiopathic VT )?

Tachycardia 98

Tachycardia Ultrasound Heart Disease Atrial Fibrillation 98

Dr. Smith's ECG Blog

JULY 17, 2023

There is a regular narrow complex tachycardia. Thus, it is supraventricular tachycardia. It is important to remember that SVT includes Sinus Tachycardia! Sometimes even Wide Complex Tachycardia is Sinus. See this case in which Lewis leads were necessary to figure this out: Wide Complex Tachycardia.

Tachycardia 98

Tachycardia Atrial Flutter Blog Exercise 98

Ken Grauer, MD

NOVEMBER 10, 2023

== — CLICK HERE — for a V ideo presentation of this case! Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #220 — == The long lead II rhythm strip shown in Figure-1 was obtained from an 51-year-old man who presented to the ED ( Emergency Department ) with "palpitations" that began 1 hour earlier.

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Blog Tachycardia Arrhythmia 189

ECG Guru

MAY 24, 2024

ECG Number 1, 11:57 a.m.: There is a wide-complex tachycardia at a rate of about 230 bpm. We do not have information about her past medical history. We will update this post if we receive information about her outcome. The QRS is.15 15 seconds (150 ms). The QRS frontal plane axis is leftward.

Tachycardia 98

Tachycardia Outcomes 98

Journal of Cardiovascular Electrophysiology

MARCH 17, 2025

Distribution Variance of Focal Atrial Tachycardia Foci and Long-Term Outcomes After Ablation. ABSTRACT Introduction The distribution of the origin of focal atrial tachycardia (FAT) in patients with different ages have not been clearly elucidated.

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Tachycardia Ablation Outcomes Tricuspid 40

Dr. Smith's ECG Blog

JANUARY 9, 2024

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. Said differently, the ECG shows a rather slow ventricular tachycardia with a 2:1 VA conduction. Cardiac output (CO) was being maintained by the tachycardia.

Tachycardia 120

Tachycardia Electrophysiology Atrial Flutter Ischemia 120

Medical Xpress - Cardiology

OCTOBER 8, 2024

A multicenter study has described and validated a new strategy for guiding ablation procedures in patients with complex tachycardias. This type of procedure is frequently used to treat ventricular tachycardias originating in areas affected by scarring after a myocardial infarction.

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Tachycardia Myocardial Infarction Heart Rhythm Ablation 81

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

I find AV dissociation in VT to be very difficult to differentiate from artifact, as there are always random blips on tachycardia tracings. Read this post: Idiopathic Ventricular Tachycardias for the EM Physician 2. The 15th beat (2nd beat of V1-V3) appears to be a fusion beat , which is all but diagnostic of VT.

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Tachycardia Cardiogenic Shock Angina Coronary Angiogram 139

Dr. Smith's ECG Blog

JUNE 21, 2024

A patient in the ICU with significant underlying cardiac disease [HFrEF 30%, non-ischemic cardiomyopathy, LBBB s/p CRT-D (biventricular pacer), AVNRT s/p ablation a few yrs ago, hx sinus tachycardia while on max tolerated BB therapy] went into a regular wide-complex tachycardia after intubation for severe COPD exacerbation. What to do?

Tachycardia 71

Tachycardia Atrial Fibrillation Pacemaker Blog 71

Medical Xpress - Cardiology

JANUARY 10, 2024

Patients with post-COVID-19 vaccination postural orthostatic tachycardia syndrome (POTS) all have preexisting conditions, according to a study published in the January issue of Heart Rhythm.

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COVID-19 Tachycardia POTS Heart Rhythm 85

The New England Journal of Medicine

FEBRUARY 19, 2025

Among patients with ventricular tachycardia and ischemic cardiomyopathy, catheter ablation as an initial therapy led to a lower risk of adverse outcomes than antiarrhythmic drug therapy.

Tachycardia 71

Tachycardia Ablation Cardiomyopathy Outcomes 71

HeartRhythm

JANUARY 25, 2024

Differentiating between atypical atrioventricular node re-entrant tachycardia (aAVNRT) and orthodromic reciprocating tachycardia (ORT) utilizing a septal accessory pathway is a complex challenge.

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Tachycardia 75

Dr. Smith's ECG Blog

JUNE 11, 2023

The ECGs show a wide complex, irregularly irregular tachycardia. At that time, he presented via EMS and had received magnesium and lidocaine prehospital for concerns of ventricular tachycardia. On arrival to the ED, he was noted to be in a wide complex tachycardia with a rate in the 240s.

Tachycardia 98

Tachycardia Atrial Fibrillation Chest Pain Blood Pressure 98

Heart BMJ

FEBRUARY 12, 2025

Scar-related re-entrant atrial tachycardias and atrial fibrillation (AF) are the most common types of AA, but focal atrial tachycardias, atrioventricular re-entrant tachycardia using an accessory pathway and atrioventricular nodal re-entrant tachycardia are also encountered.

Congenital Heart Disease 59

Congenital Heart Disease Congenital Heart Failure Arrhythmia 59

Frontiers in Cardiovascular Medicine

FEBRUARY 24, 2025

Tachycardia of >140 (AOR=7.50, 95% CI: 1.36, 41.57), any degree of left ventricular dysfunction, Killip class IV (AOR=6.03, 95% CI: 1.27, 28.61), and non-initiation of betablockers (AOR=0.17,95% CI: 0.05, 0.63) were significantly associated with increased in-hospital mortality. Percutaneous Coronary Intervention was performed for 12.3%

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Hospital Myocardial Infarction Chest Pain Electrocardiogram 98

Circulation

JANUARY 6, 2025

BACKGROUND:Current outcomes from catheter ablation for scar-dependent ventricular tachycardia (VT) are limited by high recurrence rates and long procedure durations. Circulation, Ahead of Print.

Tachycardia 85

Tachycardia Ablation Technology Electrophysiology 85

American College of Cardiology

NOVEMBER 16, 2024

The goal of the VANISH2 trial was to compare endocardial catheter ablation with conventional antiarrhythmic drug (AAD) therapy as a first-line treatment for infarct-related ventricular tachycardia (VT) in ischemic cardiomyopathy.

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Tachycardia Ablation Heart Disease Cardiomyopathy 66

Ken Grauer, MD

OCTOBER 10, 2024

QUESTIONS: Is this rhythm too fast to be sinus tachycardia? However, until such time that we know for certain — I think it best to simply describe what we see: PEARL # 1: Realize that for any tachycardia — there are 6 Parameters that need to be assessed. Are flutter waves hidden within the QRS and T waves? s in Figure-2 ).

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Blog Tachycardia Atrial Flutter 164

Heart BMJ

JULY 10, 2024

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.

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Tachycardia Aortic valve Coronary Artery Disease Atrial Fibrillation 102

Journal of Cardiovascular Electrophysiology

SEPTEMBER 16, 2024

Abstract Introduction Understanding the spatiotemporal location of the spontaneous termination of ventricular tachycardia (VT) may provide new insights for ablation.

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Tachycardia Ablation Electrophysiology Article 75

Dr. Smith's ECG Blog

JANUARY 23, 2024

Shortly after isoprenalin infusion was initiated, there were short runs of ventricular tachycardia. During the next 24 hours, she experienced periods of complete AV block with a ventricular escape rhythm in the 20s. She was started on isoprenalin (isoproterenol). The following ECG was recorded during one of these episodes of VT.

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Tachycardia Arrhythmia Heart Disease Sudden Cardiac Death 108

Dr. Smith's ECG Blog

FEBRUARY 16, 2024

But it is not disorganized enough to be polymorphic ventricular tachycardia. Learning Points: Wide complex irregularly irregular tachycardias include PMVT, AF with WPW, and AF with aberrancy. See our other cases of AF with WPW: A young man with another episode of tachycardia. What do you want to do? Smith : I always cardiovert.

Tachycardia 136

Tachycardia Atrial Fibrillation Chest Pain Blood Pressure 136

Dr. Smith's ECG Blog

JUNE 2, 2023

She was awake, alert, well perfused, with normal mental status and overall unremarkable physical exam except for a regular tachycardia, possible rales at both bases, some mild RUQ abdominal tenderness. Thus, I believe it is a regular, monomorphic, wide complex tachycardia. Or it could simply still be classic VT. What is the Diagnosis?

Tachycardia 96

Tachycardia Cardiomyopathy Electrocardiogram Article 96

Journal of the American Heart Association

FEBRUARY 3, 2025

These result in diagnoses such as postural orthostatic tachycardia syndrome and orthostatic hypotension. Because CBF is not easy to measure, rises in heart rate or drops in blood pressure are used as proxies for abnormal CBF.

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Blood Pressure Ultrasound Quality of Life Tachycardia 76

ECG Guru

DECEMBER 18, 2023

If a wide complex tachycardia occurs, the probability is very high that it is a ventricular tachycardia (approx. Here we see a broad complex tachycardia that looks like an RBBB + LAFB, which is regular. 80%, in patients with a previous myocardial infarction (.) In this constellation, 3 causes must be considered: 1.

Myocardial Infarction 116

Myocardial Infarction Tachycardia 116

Ken Grauer, MD

MARCH 23, 2023

C ASE C onclusion : I lack detailed follow-up from today's case — other than knowing that the Atrial Tachycardia was controlled. This type of Wenckebach response that may be seen with atrial tachycardia ( or atrial flutter ) — is often physiologic, as a result of the rapid atrial rate that occurs with these arrhythmias.

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Blog Tachycardia Arrhythmia Atrial Flutter 78

Ken Grauer, MD

DECEMBER 12, 2024

I was sent the ECG in Figure-1 initially told only that it was obtained from an older man with palpitations. The cardiology team thought the rhythm was an SVT ( S upra V entricular T achycardia ) with QRS widening as a result of aberrant conduction.

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Blog Tachycardia Heart Disease Congenital Heart Disease 82

Open Heart

FEBRUARY 17, 2025

Oral anticoagulants (OAC) were administered at baseline in 69.5% of the patients.

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Atrial Fibrillation Cardiomyopathy Research Defibrillator 88

Medical Xpress - Cardiology

DECEMBER 19, 2023

Heart rates are easier to monitor today than ever before. Thanks to smartwatches that can sense a pulse, all it takes is a quick flip of the wrist to check your heart. But monitoring the cells responsible for heart rate is much more challenging—and it's encouraged researchers to invent new ways to analyze them.

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Research Tachycardia 103

Frontiers in Cardiovascular Medicine

JANUARY 10, 2024

However, widely split P' waves in focal atrial tachycardia (AT) on a surface electrocardiogram (ECG) have rarely been reported. An electrophysiological study showed that the tachycardia arose from the left atrial appendage (LAA) and was conducted through two distinct pathways.

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Tachycardia Electrophysiology Atrial Fibrillation Electrocardiogram 59

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.

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Tachycardia Pulmonary Blood Pressure Blog 139

Dr. Smith's ECG Blog

JANUARY 2, 2025

Even with tachycardia and a paced QRS duration of ~0.16 (J Am Coll Cardiol. second I immediately knew there is no way this relative increase in QT duration ( compared to the R-R interval ) is going to be "normal". 2 Quick Approximations that I Use: As I discuss in My Comment in the March 19, 2019 post in Dr.

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Tachycardia Cardiomyopathy Blog Bradycardia 116

Ken Grauer, MD

JUNE 22, 2024

The ECG in Figure-1 — was obtained from a middle-aged woman with positional tachycardia and diaphoresis with change of position from suprine to sitting. My THOUGHTS on the ECG in Figure-1: The rhythm is sinus tachycardia at ~105/minute ( ie, The R-R interval is regular — and just under 3 large boxes in duration ).

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Blog Ischemia Tachycardia Cardiomyopathy 171

Dr. Smith's ECG Blog

OCTOBER 1, 2024

when the usual negative P wave deflection of sinus tachycardia is nowhere to be found in lead V1 )? While of course possible for the rhythm in ECG #1 to be either AFlutter or fascicular VT — sinus tachycardia immediately becomes a much more likely possibility once we know that this patient is critically ill with multisystem disease.

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Tachycardia Cardiogenic Shock Arrhythmia STEMI 113