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Clinical case studies

Is this ventricular tachycardia?

Atrial flutter or supraventricular tachycardia with block can often give the appearance of a bidirectional tachycardia, which can be caused by many other things. In this latest case study, our Medical Director Assoc Prof Harry Mond explains how to identify the characteristics of a tachycardia by using a series of ECG tracings, as well as explaining how he reached the correct conclusion when asked whether an ECG was showing a ventricular tachycardia.

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Clinical case studies

It’s all in the timing

Overnight Wenckebach AV block is a common finding in young people and is usually found in the presence of sinus bradycardia/sinus slowing. In this latest edition in our clinical case studies series, we look at how to identify atypical Wenckebach AV block, and how it’s affected by timing.

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Clinical case studies

A bizarre ECG

Not all ECG recordings are straightforward, as illustrated by this "bizarre" ECG. In this latest edition in our clinical case studies series, our Medical Director Dr Harry Mond explains how he assessed an ECG he was asked to look at, and how eliminated incorrect solutions to the symptoms being presented.

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Clinical case studies

Is this Wenckebach?

Reversed Wenckebach occurs when there is sequential shortening of the PR interval, and can require a permanent pacemaker in certain instances. In this latest case study, we take a look at examples of reversed Wenckebach, and how to recognise the rare ECG finding.

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Clinical case studies

A bradycardia with pacing

All pacemaker companies have programmable algorithms to prevent ventricular pacing, but this can cause issues with Holter monitor test results. Our Medical Director, Dr Harry Mond, explains how pacemakers can confuse Holter monitor tracings, and how to correctly identify these algorithms on ECG patterns.

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Clinical case studies

The Wandering Atrial Pacemaker

As a rare find Wandering Atrial Pacemaker can be mistaken for marked sinus arrhythmia with unifocal atrial ectopics. Here, we look at the tell-tale characteristics that set them apart in another interesting case study by Medical Director Dr Harry Mond.

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Medical Papers

Underutilisation of Ambulatory ECG Monitoring After Stroke and Transient Ischemic Attack

Atrial fibrillation (AF) is the leading cardiac cause of stroke. and its identification after a stroke or transient ischemic attack (TIA) is important for guiding secondary prevention management. However, paroxysmal AF frequently goes undetected and untreated if sufficient ECG monitoring is not performed. This study underscores the need for clinicians and policymakers to address the gap between recent evidence regarding the effectiveness of ECG monitoring for AF detection and real-world practices.

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Clinical case studies

Isorhythmic AV dissociation with idioventricular rhythm

A recent ECG was reported as sinus rhythm with intermittent bundle branch block – but this diagnosis was incorrect. CardioScan’s Medical Director Dr Harry Mond discusses the identifying factors in the ECG, and how he reached his diagnosis of an idioventricular rhythm with isorhythmic AV dissociation.

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Medical Papers

The Electrocardiographic Footprints of Atrial Ectopy

The term ectopic means ‘‘out of place” or ‘‘abnormal position” and, in relation to the heart, refers to an early heartbeat, whose origin is from a focus other than the sinus node. They increase in frequency with age and are generally innocent, unless there is an underlying cause. The ECG footprints of atrial ectopy are prematurity and a non-sinus P wave morphology. Additionally, variable AV conduction, post-ectopic compensatory (or otherwise) pauses and QRS widening due to aberrant conduction may all be observed and all should be considered, when interpreting this common electrophysiology phenomenon.

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Medical Papers

The Electrocardiographic Footprints of Ventricular Ectopy

The term ectopic means “out of place” or “abnormal position” and, in relation to the heart, refers to an early or premature heartbeat, whose origin is from a focus other than the sinus node. Ventricular ectopics originate from an irritable focus within the ventricles and clinically they may be asymptomatic or described by the patient as an “extra” beat, “missed” beat or irregular pulse. Ventricular ectopics may occur in groups including bigeminy, trigeminy, couplets and triplets. Very frequent ventricular ectopics may result in a potentially reversible ectopy-mediated cardiomyopathy.

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