Atrial fibrillation electrocardiogram

Electrocardiogram (ECG) May be normal or could show numerous abnormalities including acute ST-T-wave changes from myocardial ischemia, atrial fibrillation, bradycardia, and LV hypertrophy. 

The electrocardiogram will determine whether the patient has atrial fibrillation, which is a major risk factor for stroke. 

The electrocardiogram will determine whether atrial fibrillation is present. 

Electrocardiograms typical of a variety of arrhythmias. SVT, supraventricular tachycardia AFL, atrial flutter AFib, atrial fibrillation VT, ventricular tachycardia VT-TdP, ventricular tachycardia of the torsade de pointes type. 

A 44-year-old woman took an overdose of venlafaxine 3 g. An electrocardiogram showed sinus rhythm and incomplete right bundle branch block (32). She was monitored in an intensive care unit and 10 hours later a further electrocardiogram showed atrial fibrillation with a wide QRS complex. Both of these abnormalities resolved with sodium bicarbonate (100 ml of a 1 M solution). No further conduction disturbances were noted over the following days. 

A 44-year-old man with no significant cardiac history was given clozapine and 12 days later had bibasal crackles in the chest and ST segment elevation in leads V2 and V3 of the electrocardiogram. He then developed ventricular tachycardia and needed resuscitation. He also developed atrial fibrillation for 24 hours, which subsequently resolved. 

A healthy 32-year-old doctor, who smoked marijuana 1-2 times a month, had paroxysmal tachycardia for several months. An electrocardiogram was normal and a Holter recording showed sinus rhythm with isolated supraventricular extra beats. He was treated with propranolol. He later secretly smoked marijuana while undergoing another Holter recording, which showed numerous episodes of paroxysmal atrial tachycardia and atrial fibrillation lasting up to 2 minutes. He abstained from marijuana for 12 months and maintained stable sinus rhythm. 

A 65-year-old man with atrial fibrillation was given intravenous amiodarone 450 mg over 30 minutes followed by 900 mg over 24 hours (54). He reverted to sinus rhjdhm, but the electrocardiogram showed giant T wave alternans with a variable QT interval (0.52-0.84 seconds). He had a short bout of torsade de pointes and was given magnesium. Two days later the electrocardiogram was normal. 

Cardiac dysrhythmias occurred during a disulfiram + alcohol test in a 48-year-old man who had been an alcoholic for 5 years (6). After drinking a test amount of alcohol, he developed flushing, nausea, vomiting, sweating, dyspnea, and hyperventilation, palpitation, tremor, confusion, and syncope. The electrocardiogram showed atrial fibrillation and non-sustained bouts of ventricular tachycardia of 7-8/minute. He also had severe hypotension. 

Figure 12.2 Electrocardiograms from a horse undergoing treatment for atrial fibrillation, (a, b) Base-apex (a) and modified base-apex (b) electrocardiograms after treatment with quinidine sulfate (330mg/kg). Ventricular tachycardia, (torsades de pointes) occurred after 40 h. (c) The horse was treated with five bolus doses of magnesium sulfate, together with intravenous propanoloi, which resulted in conversion to normal sinus rhythm with QRS prolongation, (d) Twenty-four hours after conversion, the electrocardiogram showed normal sinus rhythm without QRS prolongation.

Initial laboratory data included a blood ethanol of 190 ing/dL, hut electrolytes were normal. An electrocardiogram revealed atrial fibrillation with a high degree of atrioventricular block The ventricular rate did not exceed 50/min. Atropine had no effect on the ventricular rate and a transvenous pacing catheter iros therefore inserted, with ventricular pacing instituted at 60/min. 

Toxicity due to propafenone at what was expected to be a therapeutic dose occurred in a 72-year-old woman who developed impaired consciousness and hypotension. She was also taking verapamil, the dose of which had recently been increased to 80 mg tds. An electrocardiogram showed atrial fibrillation... 

Cardiovascular A 56-year-old man with hypertension had a 62% total body surface area burn and developed atrial fibrillation, for which he was given digoxin [IT ]. Pyloroplasty for a bleeding ulcer led to postoperative ileus for which intravenous metoclopramide 20 mg was given every 6 hours. Beginning on day 54, he had seven episodes of bradycardia and 15 episodes of asystole over 48 hours. Some episodes required atropine, while others resolved spontaneously. Some attacks converted initially to a junctional rhythm, and all ultimately reverted to sinus tachycardia. Serial electrocardiograms were normal. Digoxin and metoclopramide were withdrawn and several hours later the brady-dysrhythmias resolved. Metoclopramide... 

At less than 2% in the clinical investigations acute renal failure, atrial fibrillation, cerebrovascular accident, sepsis, meningitis, psychotic disorder, suicidal ideation, respiratory distress, rhabdomyolysis, electrocardiogram abnormal, stupor, loss of consciousness, incoherent, clonic convulsion and grand mal convulsion. Rare instances of fatal pneumonia aspiration and suicide attempt were reported (<1%). 

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