Arron Pearce @Arron_Pearce_
ECG enthusiast and ECG interpreter at Broomwell Healthwatch - Managing Broomwell's social media - Nurse by trade - Millennial (Background ECG is pre-excited AF) Manchester, England Joined September 2010-
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Arron Pearce retweeted
23 yo female with palpitations for hours since 5 years; 1. ECG: 6 leads; second ECG: Holter strip; what is the most likely diagnosis of this WCT? @willyhfrick @IrmaMDv @The_Nanashi_O @AThomazAndrade @DidlakeDW @BrooksWalsh @anais_dahoumane @PacingSpike
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Arron Pearce retweeted
There is an underlying sinus bradycardia (atrial rate 55/min) but with a simultaneous accelerated junctional rhythm (discharge rate 80/min). Most beats are junctional but there are also sinus capture beats (‘C’), producing incomplete AV dissociation. There is no AV block.
Arron Pearce retweeted
Not particularly difficult but good for practising rigorous, systematic analysis. What is the rhythm? #ECG
What are the two main findings present here? I have never seen these two uncommon findings, co-exist on the same ECG. #epeeps
Note the deterioration in P wave morphology. ECGs are 2.5 years apart and represent a worsening delay of atrial conduction (inter-atrial block - IAB). Elderly female complaining of palpitations and fainting. IAB often predisposes patients to AF, symptoms may correlate with PAF.
A case where a PAC triggers a short run of WAP 🤔 Middle-aged female with palpitations and chest tightness (but asymptomatic during ECG)
Lead reversals and electrode misplacement can cause alterations in morphology, leading to erroneous interpretation. This is the first time that I have seen it obscure rhythm analysis. LA ↔️ RL hiding atrial activity, but if you look carefully, you can still see 2:1 conduction
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3K Followers 1K Following Heart Doctor ❤️ | BHF Research Fellow @kingscardio 🇬🇧 | Team @REVIVED_BCIS2 💊 | Wales 🐲 | Aspiring plumber 👩🔧 | @TheBJCA Treasurer 💰 | #LFC ⚽️23 yo female with palpitations for hours since 5 years; 1. ECG: 6 leads; second ECG: Holter strip; what is the most likely diagnosis of this WCT? @willyhfrick @IrmaMDv @The_Nanashi_O @AThomazAndrade @DidlakeDW @BrooksWalsh @anais_dahoumane @PacingSpike
@ecgandrhythmRoe @willyhfrick @IrmaMDv @The_Nanashi_O @AThomazAndrade @DidlakeDW @BrooksWalsh @anais_dahoumane @PacingSpike SR, intermitt. WPV w. AVRT
@ecgandrhythmRoe @willyhfrick @IrmaMDv @The_Nanashi_O @AThomazAndrade @DidlakeDW @BrooksWalsh @anais_dahoumane @PacingSpike Nice! 1 ECG intermittent pre-excitation, 2 ECG Antidormic AVRT
@ecgandrhythmRoe @willyhfrick @IrmaMDv @The_Nanashi_O @AThomazAndrade @DidlakeDW @BrooksWalsh @anais_dahoumane @PacingSpike Intermittent antidromic AVRT
@ecgandrhythmRoe @willyhfrick @IrmaMDv @The_Nanashi_O @AThomazAndrade @DidlakeDW @BrooksWalsh @anais_dahoumane @PacingSpike 【1st ECG】 ・Sinus rhythm with 1° AV block ・"Intermittent WPW syndrome" →①Delta wave, ②short PR interval, ③wide QRS, ④secondary ST-T change 【2st ECG】 ・WCT, RR regular ➥s/o "Antidromic AVRT"
@ecgandrhythmRoe @willyhfrick @IrmaMDv @The_Nanashi_O @AThomazAndrade @DidlakeDW @BrooksWalsh @anais_dahoumane @PacingSpike antidrome avrt 100 %
@ecgandrhythmRoe @willyhfrick @IrmaMDv @The_Nanashi_O @AThomazAndrade @DidlakeDW @BrooksWalsh @PacingSpike Intermittent ventricular pre-excitation > probably antidromic AVRT
Practice question Me
@HishamMD3 @ecgrhythms @drahmedmohsen85 @HaseebEPHF @syamkumarmd @DidlakeDW @smithECGBlog @EF_Cardiaca @ECGcases @The_Nanashi_O @AThomazAndrade @Arron_Pearce_ @DrRazi4 @UlhasDr @EM_RESUS Hi my friend, please post your ECGs orientated correctly, it is much easier for us to assess the ECG and make a proper diagnosis 😊
@Arron_Pearce_ @jalosmar thank you for the information
@Arron_Pearce_ 2nd degree SA block + WPW pattern
@jalosmar @Arron_Pearce_ but I can’t see a delta wave
@Arron_Pearce_ 😲😲😲😲😲 "TypeA WPW syndrome"(Accessory pathway seems to be located at the left lateral side)+"SSS typeⅡ"(Mobitz typeⅡ SA block or Sinus arrest) I have never seen "any ECGs lilke this"…😳😳😳😳😳 What cause of these findings above is there in this ECG❓
@Arron_Pearce_ @Carlos_Penate6 @ecgandrhythmRoe @ecgrhythms @DidlakeDW Great explanation, makes sense, thanks a lot!
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