I have a rhytm strip that I want to challenge you with. It is a 65 years old male who has an ICD implanted with a DDD pacemaker integrated. He has heart...
Looks to me like this is PMT (pacemaker mediated tachycardia) and the PVARP should be extended. One easy test to do is to place a magnet on the device and...
My knowledge about pacemakers is limited. What is the underlying mechanism when this happens in a DDD pacemaker? Has it got anything to do with faulty sensing...
Haven't done this. What kind of Magnet do you use? ... From: Klaus Skrudland <lapsklaus@...> Subject: Re: [ekg_club] EKG - What is happening here To:...
It is all about timing and retrograde conduction. The most common, but not the only cause, is a PVC. The pacemaker sees the PVC and the patient has a...
Some of you have heard my description of cases resulting in the Nudell Sign. I had a case very recently (HIPPA proofed) that went like this: 80 yowm with...
Nick, This old brain has hiccuped. Remind me what Nudell's sign is, please. Gene ... ************** The Average US Credit Score is 692. See Yours in Just 2...
No problem Gene. I've only seen it at the time of cardiac arrest before... Pale/ghostly white skin inferior to nipple line while cyanotic/ecchymosis superior ...
It sounds like it could have been Nudell Sign. I've seen this once in a patient with (suspected) massive PE. Classic history (recently had been on a long...
Hi Jenna, Great story. I'm not positive this pt actually had bona fide seizures. He was one of about five seizure dispatches that day (something in the ...
Oh sure. Now I remember. Yes, I have seen it many times, and always with a catastrophic even such a PE. Gene ... ************** The Average US Credit Score...
What is suspicious about this ECG? I know nothing about the history or clinical presentation. Tom -- Tom Bouthillet Lieutenant / Paramedic Town of Hilton Head...
Suspicious for posterior MI... ST depression in V1-4, prominent R wave in V2. ? Do only suspected STEMIs get sent to the Lifenet station, or ? ? ? Jon Kavanagh...
Jon - Right now, all sorts of things get transmitted to the Lifenet. Tom ... -- Tom Bouthillet Lieutenant / Paramedic Town of Hilton Head Island Fire & Rescue...
Jenna, Â Can you please explain the S1Q3T3 phenomenon? I have heard it before but never really understood what it was representing. Â Christopher Linke ... ...
Prominent S wave in Lead I, prominent Q wave in Lead III and inverted T wave in Lead III It was previously mentioned on this list that this sign shows up on ...
A colleague of mine told me today that last week a hospital doctor she worked with administered iv adenosine to a patient, trying to terminate a wide-complex...
It used to be in the "wide complex tachycardia of unknown origin" algorithm, but it's not anymore. I wouldn't necessarily say it's contraindicated for a ...
"Thoughtful" meaning that he suspected that the tachycardia was supraventricular with BBB or aberrancy? I would assume that when adminstering adenosine to a...
Excuse me, but how come you are displaying SEVERAL of my own ECG's, from my own website even using my OWN interpretations and texts?? And you still have the...
Some are "thoughtful." Some just think of adenosine as a completly safe diagnostic agent. The only way completely and safe go together is when they are held...
I don't know, Klaus. They do some wild stuff in the EPS lab. Tom ... -- Tom Bouthillet Lieutenant / Paramedic Town of Hilton Head Island Fire & Rescue Division...
Now what if the wide-complex tachycardia is actually an antidromic AVRT? Wouldn't adenosine be able to accelerate conduction through the accessory pathway? ......
Yes, I suppose it could. I don't recommend giving adenosine to wide complex tachycardias of unknown origin. I'm just acknowledging that physicians have a...
Good answer. Let's hope he knew what he was doing. I'll check out that case you're mentioning. By the way, do you (or anyone else) know of any good books on...
This is a patient that I had in the ER the other day. I'd say that this ECG has pretty clear morphologic clues to what kind of tachycardia this is.. The...
What is Norwegian for "went crazy"? Tom ... -- Tom Bouthillet Lieutenant / Paramedic Town of Hilton Head Island Fire & Rescue Division 843-247-3453 (cell) ...
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