Key Points Definition: Slow ventricular tachycardia is defined as a wide complex tachycardia with a ventricular rate between 100–120 bpm. Distinction: Typical sustained VT usually exceeds 120 bpm. When encountering…
Key Points Definition: Sinus pause/arrest is failure of the sinus node to generate an impulse, producing a transient absence of P waves. On ECG the pause does not equal an…
Key Points Definition: The R on T phenomenon occurs when an ectopic impulse (often a PVC or cardioversion shock) falls on the T wave of the preceding beat. Mechanism: Interrupting…
Key Points Definition: Multifocal Atrial Tachycardia (MAT) is a rare type of irregularly irregular supraventricular tachycardia (SVT) characterized by the presence of at least three or more different P wave…
Key Points: Clinical Context: Abnormal ECGs must be interpreted within the patient’s presentation. Not all abnormalities are life-threatening, and high-risk conditions can still appear subtle or even “normal.” Serial Monitoring:…
Key Points RV involvement accompanies up to ~40% of inferior STEMIs; isolated RV infarction is uncommon but high-impact when missed. Think RV MI when inferior STEMI is present and you…
Key Points: Definition: Sudden failure of AV conduction after at least two consecutive conducted beats with identical PR intervals, followed by a single non‑conducted P wave. Sinus rate: P–P interval…
Key Points: ECG as a Critical Diagnostic Tool: In toxicology, the ECG is often the first and most reliable clue. Early recognition of drug-induced conduction disturbances or arrhythmias can guide…
Key Points: What it is: In V2 or V3, there is no S wave (the R does not descend below the PQ baseline) and no J wave (no notch/slur at…
Key Points Narrow therapeutic window: Small dosing errors or renal decline can push serum digoxin above the safe range. Excess automaticity + AV block: Toxicity increases atrial and ventricular irritability…
Key Points: Definition: The QRS axis reflects the net direction of ventricular depolarization and is expressed in degrees on the frontal plane. Why It Matters: Axis assessment is a fast,…
Key Points Definition: Extreme axis deviation (aka “Northwest Axis”) occurs when the QRS axis is between –90° and ±180°. ECG Clue: QRS negative in Lead I QRS negative in Lead…
Key Points Definition: LAD occurs when the QRS axis is between –30° and –90°. ECG Pattern: QRS positive in Lead I QRS negative in Lead aVF Clinical Use: LAD can…
Key Points Definition: An indeterminate QRS axis (also called “no man’s land”) occurs when the frontal QRS vector lies between –90° and ±180°, but no dominant direction is evident. ECG…
Key Points Definition: Right Axis Deviation (RAD) occurs when the QRS axis is > +90°, typically up to +180°. ECG Criteria: Negative QRS in Lead I Positive QRS in Lead…
Top 3 Emergent Causes of New Rightward Axis Deviation: When you see new RAD in an adult, immediately consider life-threatening etiologies: Acute Right Heart Strain Pulmonary embolism until proven otherwise…
Key Points Normal Axis Range: –30° to +90° Lead I: QRS complex is positive Lead aVF: QRS complex is positive → This combination confirms a normal QRS axis Frontal plane…
Key Points: Intervals are your ECG safety rails. Before you get seduced by ST segments and T waves, lock down PR, QRS, and QT/QTc. They frequently reveal the real danger…
Key Points Definition: A fusion beat occurs when two impulses — one from the normal conduction system (typically supraventricular) and one from an ectopic ventricular focus (e.g., during VT) —…
Key Points The ECG is a cornerstone of acute care medicine, offering immediate, non-invasive insight into cardiac function in critically ill patients. Its evolution spans over a century, from rudimentary…