ECG Guru - Instructor Resources - Cardioversion https://www.ecgguru.com/ecg/cardioversion en ECG Basics: Torsades Cardioverted https://www.ecgguru.com/ecg/ecg-basics-torsades-cardioverted <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-basics-torsades-cardioverted"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/124%20Cardioversion%20of%20Torsades.jpg" width="1800" height="648" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>These two strips are from one patient who was electrically cardioverted twice in a few minutes. &nbsp;The original reason for the cardioversion was Torsades de Pointes, a type of polymorphic ventricular tachycardia associated with a long QT interval. &nbsp;For more information about TDP, go to this<a title="Torsades" href="http://ecgguru.com/ecg/ecg-basics-torsades-de-pointes"> LINK.</a>&nbsp; It is a bit difficult to comment on the patient's post-cardioversion rhythm, because so little of it is shown. &nbsp;It appears to be sinus, with a wide QRS. &nbsp;The QT interval appears slightly prolonged at .44 sec, but it is not known what the QT interval is corrected to a rate of 60/min. &nbsp;TDP is often seen with QT intervals greater than 600 ms (.6 seconds). &nbsp;Also THESE STRIPS ARE NOT SIMULTANEOUS, they were taken two minutes apart. &nbsp;In the first one, the P waves and T waves look so much alike, they could all be P waves. &nbsp;They do not "march out". &nbsp;It is necessary to get a long strip, preferably in multiple leads, and a 12-Lead ECG, to properly evaluate the rhythm post-cardioversion.&nbsp;</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/389/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give ECG Basics: Torsades Cardioverted 1/5</option><option value="40">Give ECG Basics: Torsades Cardioverted 2/5</option><option value="60">Give ECG Basics: Torsades Cardioverted 3/5</option><option value="80" selected="selected">Give ECG Basics: Torsades Cardioverted 4/5</option><option value="100">Give ECG Basics: Torsades Cardioverted 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >4</span></span> <span class="total-votes">(<span >2</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-awgnL0U69WClr5YxQDcmWGYzPzBi7oRRzMC3neKqDJw" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-basics" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ECG Basics</a></div><div class="field-item odd"><a href="/ecg/ventricular-tachycardia" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Ventricular tachycardia</a></div><div class="field-item even"><a href="/ecg/v-tach" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">V Tach</a></div><div class="field-item odd"><a href="/ecg/vt" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">VT</a></div><div class="field-item even"><a href="/ecg/cardioversion" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Cardioversion</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fecg-basics-torsades-cardioverted&amp;title=ECG%20Basics%3A%20%20Torsades%20Cardioverted"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Fri, 20 Dec 2013 19:08:13 +0000 Dawn 534 at https://www.ecgguru.com https://www.ecgguru.com/ecg/ecg-basics-torsades-cardioverted#comments ECG Basics: NIPS Procedure, ICD Test https://www.ecgguru.com/ecg/ecg-basics-nips-procedure-icd-test <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-basics-nips-procedure-icd-test"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/114%20NIPS%20Procedure.jpg" width="1800" height="213" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>This is a rhythm strip from a NIPS procedure (non-invasive programmed stimulaltion), which is a programming test for an implantable cardioverter defibrillator (ICD). &nbsp;The test is done under light anesthesia, similar to that used for colonoscopy. &nbsp; In this example, the patient is in normal sinus rhythm at the beginning of the procedure. &nbsp;The pacemaker technician overdrives the patient's rate to observe the pacing function, then a stimulus is delivered to cause ventricular fibrillation (V Fib). &nbsp;Initially, the ventricular rhythm is somewhat organized and coarse (V flutter), but it will rapidly deteriorate if not corrected. &nbsp;Before it deteriorates, the ICD delivers a shock, and the patient's rhythm is restored. &nbsp;In this example, bi-ventricular pacing was conducted for a few minutes before the patient resumed NSR. &nbsp;The patient is then recovered from the anesthesia and discharged home.</p><p>For your students, this is a good example of the relative safety of shocking the well-perfused heart. &nbsp;Although it is possible to put the heart into an intractable V Fib with this test, the ICD usually is able to convert the potentially lethal rhythm easily. &nbsp;It is a good reminder that we need to perfuse the heart well before performing defibrillation on a person with unwitnessed cardiac arrest.</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/389/feed" method="post" id="fivestar-custom-widget--2" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--4" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give ECG Basics: NIPS Procedure, ICD Test 1/5</option><option value="40">Give ECG Basics: NIPS Procedure, ICD Test 2/5</option><option value="60">Give ECG Basics: NIPS Procedure, ICD Test 3/5</option><option value="80" selected="selected">Give ECG Basics: NIPS Procedure, ICD Test 4/5</option><option value="100">Give ECG Basics: NIPS Procedure, ICD Test 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.7</span></span> <span class="total-votes">(<span >7</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--2" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form--32YhDoGAZDEhuWN_a56bOYfJCpF4YrbsW8gU_1Wt_s" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-basics" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ECG Basics</a></div><div class="field-item odd"><a href="/ecg/rhythm-strip" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Rhythm strip</a></div><div class="field-item even"><a href="/ecg/nips-procedure" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">NIPS Procedure</a></div><div class="field-item odd"><a href="/ecg/icd-test" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ICD Test</a></div><div class="field-item even"><a href="/ecg/pacemaker" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Pacemaker</a></div><div class="field-item odd"><a href="/ecg/cardioversion" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Cardioversion</a></div><div class="field-item even"><a href="/ecg/defibrillation" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Defibrillation</a></div><div class="field-item odd"><a href="/ecg/ventricular-fibrillation" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Ventricular fibrillation</a></div><div class="field-item even"><a href="/ecg/vf" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">VF</a></div><div class="field-item odd"><a href="/ecg/paced-rhythm" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Paced rhythm</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_2"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fecg-basics-nips-procedure-icd-test&amp;title=ECG%20Basics%3A%20%20NIPS%20Procedure%2C%20ICD%20Test"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Fri, 27 Sep 2013 19:20:52 +0000 Dawn 499 at https://www.ecgguru.com https://www.ecgguru.com/ecg/ecg-basics-nips-procedure-icd-test#comments