Devices
Results:
Pacemaker Syndrome
Key Points Pacemaker syndrome is a hemodynamic problem caused by loss of proper atrioventricular (AV) synchrony. Most commonly occurs with ventricular pacing that produces retrograde atrial activation, but can also…
Pacemakers: Basics
Key Points Pacemakers treat bradyarrhythmias by delivering timed atrial, ventricular, or dual-chamber pacing when intrinsic activity is slow or absent. Know the major device types encountered in the ED: single-chamber,…
Pacemaker & ICD Emergencies
Key Points: Three primary pacemaker malfunctions: Failure to pace – no pacing spike when one is needed. Failure to capture – pacing spike appears but no depolarization follows. Failure to…
Paced Rhythms
Key Points Ventricular pacing changes depolarization, so ST–T segments often look “abnormal.” Expect appropriate discordance: ST/T deflect opposite the main QRS polarity. RV pacing (most common) ≈ LBBB pattern: wide…
Dysrhythmias in LVAD Patients
Key Points Continuous-flow LVADs can mask shock: patients may talk through VT/VF because pump flow maintains some perfusion. Treat the rhythm, not the appearance. First steps in any unstable LVAD…
STEMI vs Wide QRS (BBBs & Paced Rhythms): DDx
Key Points Wide QRS & Repolarization Abnormalities: Bundle branch blocks (BBBs) and ventricular-paced rhythms (RV, LV, BiV) cause abnormal ventricular depolarization, leading to secondary ST segment and T wave changes—even…
Occlusion MI in Ventricular Paced Rhythms: STEMI Equivalent Pattern
Key Points 1. Paced Rhythms and Acute MI Detection: Ventricular paced rhythms significantly alter ST segment and T wave morphology, complicating acute myocardial infarction (MI) recognition. Accurate ECG interpretation in…
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