This ECG demonstrates LBBB, Atrial Fibrillation with RVR, and Aberrancy. The patient presented hypotensive and confused. He was successfully cardioverted with 200 J after failed initial attempts with 100 J and 150 J.
By Anthony J. Hackett, DO There are several complications that should be considered when pacemakers go bad: lead failure, pocket complications and device complications. Early post placement complications: pneumothorax, hemothorax and venous thrombosis and air emboli Lead failure: -Dislodgement: More common in ICD (10%) than in pacers (5%) -Fracture: occurs where kinks in wire are […]
Anthony J. Hackett, DO Given the increasing use of pacemakers and AICD’s in medicine, it is not uncommon to encounter these devices in clinical practice. Familiarity with common errors is paramount especially given their approximately 6% per year chance of malfunction. This brief review serves to help make sense of the letters, numbers and symptoms […]
By Joel A. Miller, MD, FAAEM, FACEP Recently, we reviewed a landmark study published in the New England Journal of Medicine (NEJM Missed diagnosis of ACS in the ED_2000) that formed much of the foundation and justification of the AHA guidelines that currently guide our practice in caring for patients with chest pain. In looking […]
Anthony J. Hackett, DO Brugada syndrome was originally described by the Spanish cardiologists Pedro and Josep Brugada in 1992. It is a sodium channelopathy (SCNA5 gene) that has a high association with sudden cardiac death (SCD) and is found mainly in adult men. The defect leads to a slowed influx of sodium that interferes with […]