tag:blogger.com,1999:blog-549949223388475481.post5074190581894962066..comments2024-03-28T14:02:08.119-05:00Comments on Dr. Smith's ECG Blog: Ventricular fibrillation on a 12-lead ECGUnknownnoreply@blogger.comBlogger15125tag:blogger.com,1999:blog-549949223388475481.post-65225267485939229462018-06-12T10:40:09.024-05:002018-06-12T10:40:09.024-05:00No way it is vfib and the patient is awake "b...No way it is vfib and the patient is awake "becoming obtunded". Zero cardiac output with vfib. Anonymoushttps://www.blogger.com/profile/17811592039026628098noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-46008641171331511992017-10-11T16:49:37.336-05:002017-10-11T16:49:37.336-05:00you might like these posts:
http://hqmeded-ecg.bl...you might like these posts:<br /><br />http://hqmeded-ecg.blogspot.ca/search?q=PMVTSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-42535047721678481702017-10-07T10:36:18.810-05:002017-10-07T10:36:18.810-05:00Excellent case. I didn't found any literature...Excellent case. I didn't found any literature on the recognition from VF and PMVT. If someone had found any studies on this, I will really appreciate to see it. Thanks :)Anonymoushttps://www.blogger.com/profile/15153414433904705751noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-47647142231798624022017-02-24T18:20:26.884-06:002017-02-24T18:20:26.884-06:00On rare occasions, V Fib can convert spontaneously...On rare occasions, V Fib can convert spontaneously. See this case: http://hqmeded-ecg.blogspot.com/2014/03/ventricular-fibrillation-during.htmlSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-76187624909923393492017-02-24T08:53:19.342-06:002017-02-24T08:53:19.342-06:00Definitely my feeling also. Coarse VF looks like t...Definitely my feeling also. Coarse VF looks like torsade. But never self terminates, which is very often the case with torsades. I wonder if there is good litterature on this.Dominic Larose MD CMFC(MU) FACEPhttps://www.blogger.com/profile/12841805037815499459noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-9534194443212808212011-12-29T20:07:24.249-06:002011-12-29T20:07:24.249-06:00Good thought,but improbable. The QT is 295 ms, QT...Good thought,but improbable. The QT is 295 ms, QTc 440ms. it would be highly unusual for a single dose of amiodarone to increase the QT to the length necessary to cause torsade, especially in tachycardia. <br /><br />What I find interesting is that clinicians everywhere seem to be fascinated and obsessed with torsade, and frequently desire a chaotic rhythm to be torsade. Most rhythms that look like torsade are really fib. Especially if they occur in the setting of ischemia.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-76359257291881339352011-12-29T10:56:08.455-06:002011-12-29T10:56:08.455-06:00Would also suspect that the amiodarone, administer...Would also suspect that the amiodarone, administered after the first ECG shown, prolonged the QT and lead to polymorphic VT, which really looks like torsades... Dr. S, my understanding is the indication for amio here is for shock-refractory VF, which he didnt have. So why was amio given so early?HotCarlhttps://www.blogger.com/profile/08608168760935222324noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-1084733957190780702011-12-25T16:28:52.561-06:002011-12-25T16:28:52.561-06:00Again, torsade is by defintion polymorphic VT in t...Again, torsade is by defintion polymorphic VT in the context of a long QT on the baseline ECG. The first ECG did not have a long QT. So this can by non-torsade pulseless polymorphic VT. There is no practical difference between non-torsade polymorphic VT and V Fib. Same etiology in this case (ischemia) and same treatment (electricity).Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-22800589721195672152011-12-25T14:10:40.508-06:002011-12-25T14:10:40.508-06:00The R-R interval in the second strips seems regula...The R-R interval in the second strips seems regular to me, so it looks more like some kind of pulseless VT. <br />I find it hard to measure the QTc on the computer screen, but at least on V2 the Q-T interval seems more than half the R-R interval, which is a clue for prolonged Q-T. Can you please re-consider the option of torsades?eli alkalayhttps://www.blogger.com/profile/06950813041027542977noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-33007773002059550022011-12-20T11:17:37.982-06:002011-12-20T11:17:37.982-06:00they look the same but one is caused by things tha...they look the same but one is caused by things that prolong the QT, the other by ischemia mostly.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-22198026531495491452011-12-20T07:46:25.704-06:002011-12-20T07:46:25.704-06:00OK makes sense about the QT. So what is the comp...OK makes sense about the QT. So what is the comparison (physiology ) of polymorphic vtach that isn't torsades as compared to torsades. I know the appearience and such but what makes it different?<br /><br />Sorry having a hard time phrasing my question.Lungshttps://www.blogger.com/profile/04531209736682979225noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-61011503810321407352011-12-19T18:52:38.896-06:002011-12-19T18:52:38.896-06:00They are certainly at high risk of arrest because ...They are certainly at high risk of arrest because of widespread ischemia.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-33475087140720375952011-12-19T18:27:52.759-06:002011-12-19T18:27:52.759-06:0012-lead number ONE is very scary to me! Would you...12-lead number ONE is very scary to me! Would you say that patients with this pattern have a propensity for cardiac arrest? <br /><br />I know I have had one with this pattern that arrested in front of me. <br /><br />MikeAnonymoushttps://www.blogger.com/profile/10900423767859353173noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-30992681525999048142011-12-19T17:37:48.039-06:002011-12-19T17:37:48.039-06:00Torsade is, by definition, only in the presence of...Torsade is, by definition, only in the presence of a prolonged QT. There is no prolonged QT. Polymorphic VT is either torsade or non-torsade. There are some who might argue that this is non-torsade polymorphic VT. But it was pulseless, so it really makes no difference. V fib frequently looks like torsade. That is the point I'm trying to make. They can look identical.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-53438199320199285392011-12-19T15:10:03.304-06:002011-12-19T15:10:03.304-06:00Tell me again how this is Vfib?? Looks like torsa...Tell me again how this is Vfib?? Looks like torsades in lead II. Waaaay too regular (most of the time) in lead II.Lungshttps://www.blogger.com/profile/04531209736682979225noreply@blogger.com