#EPeeps This baby's ECG has one of my favorite findings

#EPeeps Very unusual tracings from epicardial pacemaker - mirror noise all well and good, but has anyone seen bipolar go flat like this? Note carefully EGM configuration. @narrowqrs.bsky.social

#EPeeps Don't see this so often!

ECG Cases 57 Art of Occlusion MI Part 5 – Clinical-ECG-POCUS Triptych emergencymedicinecases.com/ecg-cases-oc... #ECG #POCUS #cardiosky #ecgsky @emcases.bsky.social

#EPeeps What do you think from the dot plot? Then see below.

#EPeeps Pacemaker patient reporting two weeks of fatigue #IYKYK @narrowqrs.bsky.social

Case Record of the MGH: A 32-year-old woman presented with fatigue, myalgias, and palpitations. The cardiac rhythm was irregularly irregular, and an electrocardiogram showed findings suggestive of grouped beating. A diagnosis was made. Full case details: nej.md/4lVks2d #MedSky #CardioSky

@narrowqrs.bsky.social Thank you so much for posting this video (not finished yet). I'm really excited 🙏 youtu.be/-6Z4TB5h7lY?...

A 79-year-old man with heart failure with reduced ejection fraction and atrial fibrillation presented to the emergency department with a 2-week history of shortness of breath. 1/4 #MedSky #EmergencyMedicine #CardioSky

A 32-year-old woman presented with fatigue, myalgias, and palpitations. The cardiac rhythm was irregularly irregular, and an electrocardiogram showed findings suggestive of grouped beating. What is the most likely diagnosis in this case? 🗳️ Cast your vote before August 21: nej.md/45CFZrc #MedSky

Click BP tracing to expand. What do you think the heart rhythm is before and after the transition?

Patient with biventricular ICD, in hospital for heart failure. Sudden jump up in heart rate on tele and unusual wide complex grouped beating. What's going on? What should be done?

Pacemakers are critical in the management of bradyarrhythmias. Aldaas et al. review pacemaker fundamentals, indications, and device types, as well as the role of pacemakers in heart failure, emerging advancements, and current limitations. Learn more in NEJM Evidence: eviden.cc/4ee15iB

#EPeeps I am strangely amused by this. Epicardial pacemaker with failing atrial lead, left in place as VVI backup in case of dislodgement of new transvenous system. "V sensing episode" corresponds to interrogation of new system:

Patient is s/p cardiac surgery with temporary epicardial wires in place. This pacing behavior was seen back and forth, also correlating with 15-20 mmHg systolic BP changes. What could be done to prevent this from happening? @jeffreyvinocur.bsky.social

Patient admitted with leg injury. No history of syncope. No family history of sudden death. Any concerns? @jeffreyvinocur.bsky.social

#EPeeps Do you look closely and the presenting rhythm strip on your remotes? Answer in the reply 👇

hqmeded-ecg.blogspot.com/2025/06/ante... Does the culprit match? #ECGSky #Medsky #cardiosky

#EPeeps What explains the multiple rhythm changes across the course of this strip? Hint: there is no oversensing, undersensing, or loss of capture.

#EPeeps What do you think of this “RhythmIQ” episode captured in device logs? (One continuous strip, sorry about the awkward page break location.)

I’m very proud of Dr. Lin for his first post on the blog. #ECGSky #MedSky #CardioSky

Does the constancy of the PVC coupling interval suggest triggered mechanism? #ECGSky #MedSky #CardioSky @jeffreyvinocur.bsky.social @narrowqrs.bsky.social @shah.md @danacjohnson.medsky.social @daverichley.bsky.social @alexturinmd.bsky.social

Read our editorial at the link below! www.termedia.pl/Occlusion-my... #ECGSky #Medsky #cardiosky @ecgcases.bsky.social

Let's look at a REALLY BAD acute MI! medicusofhouston.com #ECGNerds #criticalcare #physician #nursepractitioner #physicianassistant #PA-C #ECG #EKG #ECGcourse #MedSky #ECGSky #CardioSky #Cardiology #EMedSky #MedEd #EMSky #BlueSky #MedEducation #EUSEM #ACEP #AAEM #ACEM #urgentcare

#EPeeps ECG is not the mainstay of risk stratification in Tetralogy of Fallot. That said, what started with this q R R' R'' Moved barely a year from primary prevention ICD to this

I thought I had read this somewhere but I checked to make sure I wasn't just making stuff up. It was not actually from the Kosowski paper (which I thought is where I read it), it's from this one. heart.bmj.com/content/42/4...

How many findings can you name? #ECGSky #EPeeps #cardiosky #medsky

For all my ECG nerd friends: The discussion of my last post is on my website. medicusofhouston.com #ECGNerds #ECGSky #MedSky #CardioSky #Cardiology #physician #ECG #EKG #MedEd #EMSky #BlueSky #nursepractitioner #MedEducation #EUSEM #ACEP #AAEM #ACEM #criticalcare #ECGcourse #EKGcourse

#EPeeps Are you worried by loss of ventricular capture?

60M with severe ischemic cardiomyopathy, prior inferoposterior OMI. Overall impression is VT with fusion complexes. But...fusion with what? I thought supraventricular capture at first, but I am leaning more toward fusion with unrelated PVCs now.

#EPeeps Have you checked your Sensing Integrity Counter today? There aren't always enough short V-V intervals to cause an episode to be stored (although there are in this case)

For all my ECG nerd friends: Come join us in Houston or London and be a PARTICIPANT... never just an audience! medicusofhouston.com #ECGNerds #ECGSky #MedSky #CardioSky #Cardiology #EMedSky #MedEd #EMSky #BlueSky #MedEducation #FLAME #IFEM #EUSEM #ACEP #AAEM #ACEM

Could I please have an opinion on these ECGs. They are of the same patient who is suffering from heart failure @narrowqrs.bsky.social 🙏

Sudden tachycardia. What's going on?

#EPeeps An interesting ECG. What do you learn about the rhythm? What do you learn about the pacemaker? Hint below

Just a routine EKG in the office. But some interesting findings. Premature beats, wide complex QRS's, different PR's, oh my!

Another routine EKG in the office. Patient was asked if any symptoms, answered no. Possible causes of T wave inversions?

For all my ECG nerd friends: Here is the discussion for an ECG I recently posted. It still leaves a question unanswered, but that's life! medicusofhouston.com #ECGNerds #ECGSky #MedSky #CardioSky #Cardiology #EMedSky #MedEd #EMSky #BlueSky #MedEducation #FLAME #IFEM #EUSEM #ACEP #AAEM #ACEM

Seen on tele in the ICU. Pacemaker?

This is the most interesting ECG I've seen in a long time. It was presented at the @LaheyCardiology weekly General Fellows ECG conference without any clinical history. Thoughts on this #CardioTwitter and #EPeeps?

Hyperacute T wave or not: do any of these #STEMI ECGs have #OcclusionMI? #ECG #ECGsky #cardiosky hqmeded-ecg.blogspot.com/2024/12/hype...

For the newbies and intermediate level ECG nerds... #ECGNerds #ECGSky #MedSky #CardioSky #Cardiology #EMedSky #nursesky #MedEd #EMSky #BlueSky #MedEducation #emimcc #EUSEM #ACEP #AAEM #ESEM #ASEM #ACEM #medednetwork #ECG #EKG #doctor #emergency #criticalcare #internalmedicine

For all my ECG nerd friends: For the intermediate level ECG nerds: #ECGNerds #ECGSky #MedSky #CardioSky #Cardiology #EMedSky #nursesky #MedEd #EMSky #BlueSky #MedEducation #emimcc #EUSEM #ACEP #AAEM #ESEM #ASEM #ACEM #medednetwork #ECG #EKG #doctor #emergency #criticalcare #internalmedicine

Brugada syndrome: 3 steps to diagnosis. Part of @emcases.bsky.social video series youtu.be/KQy5QpH5zDA?... #ECG #EKG #ECGsky #cardiosky

Great ECG from a friend the other day. #ECGsky #medsky #cardiosky #EPeeps

#EPeeps PVCs vs intermittent preexcitation - how to decide? Hint in the reply 👇

So we can see: (1) P waves with no sign of conduction (2) Presumed VVI pacing (3) Intermittent loss of capture (4) Irregular pacing with every 4th pacing spike early, not normal for VVI ➡️ algorithm This is the Micra capture management algorithm www.medtronicacademy.com/features/ven...

Do these strips show A.fib with aberrancy or A.fib with runs of NSVT and ventricular ectopy? (and why do you think that?)

2 different patients. EP consults on same day for wide complex tach. Compare and contrast? (slower sinus EKGs in next post)....

For in-depth telemetry learning on sinus bradycardia and similar-appearing mimics, check out this educational video👇 youtu.be/tvBpcYlvIao