tag:blogger.com,1999:blog-549949223388475481.post6816152465740727998..comments2024-03-28T14:02:08.119-05:00Comments on Dr. Smith's ECG Blog: Syncope and a Possible Type 2 Brugada MorphologyUnknownnoreply@blogger.comBlogger8125tag:blogger.com,1999:blog-549949223388475481.post-1940752604244098172016-03-30T07:25:22.177-05:002016-03-30T07:25:22.177-05:00Aiora,
Lead position always affects the morphology...Aiora,<br />Lead position always affects the morphology. If late activation is directed superior, then a more superior lead will better detect that late activation and show an r'-wave. OK?<br />Steve SmithSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-21555902611792002222016-03-29T04:33:00.873-05:002016-03-29T04:33:00.873-05:00Hi! Sorry because Im not cardiologist but neurolog...Hi! Sorry because Im not cardiologist but neurologist. I have a question: why does it appear that rSr pattern in v1 in some people only when you put that lead high? Is it common? If i saw that i would think of brugada! Thanks!Aiora Ostolazahttps://www.blogger.com/profile/09804829075914285000noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-50228111195912318842015-04-30T15:49:59.140-05:002015-04-30T15:49:59.140-05:00No. Etiology uncertain.No. Etiology uncertain.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-2092229206225508792015-04-25T19:50:05.320-05:002015-04-25T19:50:05.320-05:00Dr. Smith you said he had syncope once before.. wa...Dr. Smith you said he had syncope once before.. was an etiology suspected or identified?Chris Bronsonnoreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-69315853407181112712015-04-25T16:48:34.027-05:002015-04-25T16:48:34.027-05:00Andrew,
Now I will admit that is confusing! This ...Andrew,<br />Now I will admit that is confusing! This is the way I understand it: Recording too high can be a false positive for Brugada. However, if there is a potential Brugada on an ECG with well placed leads, it must also show up on higher leads; if it does not, that is good evidence against Brugada. It may be important in cases of high suspicion for transient or concealed Brugada syndrome to detect Brugada when it does NOT show in the 4th intercostal space.<br />Read this article: http://www.csanz.edu.au/documents/guidelines/clinical_practice/Brugada_Syndrome.pdf<br />And this article: http://onlinelibrary.wiley.com/doi/10.1111/anec.12241/fullSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-21643952275255318822015-04-25T16:42:15.461-05:002015-04-25T16:42:15.461-05:00That is a mistake in my book! Sorry about that.That is a mistake in my book! Sorry about that.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-14008485843613825062015-04-25T14:21:48.786-05:002015-04-25T14:21:48.786-05:00I thought detection of these changes was improved ...I thought detection of these changes was improved by placing the leads 1-2 spaces higher.Andrewhttps://www.blogger.com/profile/04062124855639539500noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-13657665047613256342015-04-25T12:16:32.129-05:002015-04-25T12:16:32.129-05:00Steve thanks for clarifying the lead placement pea...Steve thanks for clarifying the lead placement pearl, but in your book it states to place V1-2 in the 3rd intercostal space. Is this something we need to remember to change in our book?onearmwonderhttps://www.blogger.com/profile/05544700853612013444noreply@blogger.com