Discover and read the best of Twitter Threads about #Tachyarrhythmia

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There’s a bit of a loophole in the ACLS protocols that allows afib at its worst to get away with murder.

Let’s look at two scenarios and vote about a #cardioversion decision.

#Tachyarrhythmia #tweetorial

1/7
Scenario/poll 1:

70 yo, has severe aortic stenosis, admitted with pneumonia. She was eating dinner -> suddenly complained of palpitations then became unresponsive.

Preceding: BP 98/67, HR 90 in sinus.

Now: BP 48/30, HR 180s in a-fib, pulse very thready but palpable.

Do you:
Scenario/poll 2:

Same patient and history: severe aortic stenosis, admitted w pneumonia, sudden palpitations -> unresponsiveness.

VS earlier: BP 98/67, HR 90 in sinus.

Now: BP cuff not reading, HR 180s in a-fib, no convincing pulse.

Do you:
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