Samir rafla ecg quiz from saudi arabia cardiology conference 2013

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ECG Quiz

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Samir rafla ecg quiz from saudi arabia cardiology conference 2013

  1. 1. ECG Quiz from Gulf and Saudi Conference 2013 Collected by Professor Samir Rafla Alexandria University smrafla@hotmail.com (Attended the conference) Answer follows each ECG
  2. 2. • WPWs • Right posterior • EPS to ablate
  3. 3. • Long QT • Start BB
  4. 4. • EP study, if sustained V tach. is inducible implant ICD. If not inducible give amiodarone.
  5. 5. • Catecholaminergic arrhythmia. Start Beta blockers and amiodarone. • ICD in this 13 y boy is second option.
  6. 6. • Short QT with high take off, incomplete RBB. • Leave him alone, no intervention or drugs. • Short QT is said to be present if QT is < 360 ms
  7. 7. • Pacemaker induced cardiomyopathy • Upgrade to CRT
  8. 8. • Brugada syndrome • ICD is the prober management.
  9. 9. • High take-off (LII), short QT • ICD is indicated
  10. 10. • Short QT • Start amiodarone.
  11. 11. • The answer is evident, the lead is broken and induces inappropriate shocks. Immediately magnet is put on the ICD to stop its function till lead is changed. • ICD Lead fracture is one of the causes of inappropriate shocks. Other causes as pacemaker program misinterpret sinus tachycardia or AF as VT
  12. 12. • Recording from ICD memory prove that there was no VF and the shock was given inappropriately.
  13. 13. • The diagnosis is pericarditis: evidence is diffuse ST elevation, PR depressed. • Start high dose of aspirin and follow up.
  14. 14. • Brugada syndrome • ICD is mandatory as he got VF
  15. 15. • Early repolarization. • No intervention or evaluation.
  16. 16. • Long QT • Non of the above.
  17. 17. • Arrhythmogenic RV dysplasia, notice the epsilon wave in V1. • Ablation of arrhythmogenic focus in RV outflow is needed. Recurrence is expected and redo ablation is to be done.
  18. 18. • Extensive anterior MI

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