‘VT’ versus ‘SVT with aberrancy’.

The long list of VT "suggestive" ECG features is difficult to recall and apply in real time.

How can we simplify things?

Here is my ABCDE approach – five simple Qs to ask:
🧵👇 Firstly, no single ECG feature is ‘diagnostic’ of VT.

However, the following five ECG features are highly specific for VT (85-100%).

Their presence indicates VT is likely, however their absence does NOT exclude VT.

Recalling them is as easy as ABCDE...

Differentiating regular narrow and wide complex tachycardias can be a challenge.

Can't see any P waves?

Here are three handy tricks to make things easier
🧵👇 #1: Double the paper speed

Paper output speed is the rate at which the ECG machine produces a trace. Standard output is 25mm per second.

Doubling the standard rate causes the ECG to appear drawn out. 1 small square now becomes 0.02 seconds.

Writing an #ECG talk for @ICEM2022 and couldn't find an algorithm for approaching the "fixed" regular narrow complex tachycardia. Thought I would create my own.

#FOAMed @acemonline @ICEM2022 @acemonline All this talk about VT versus SVT and it seems no one talks about an approach to regular narrow complex tachycardia.

Well, basic principles. Regular narrow complex tachycardias are either re-entrant, automatic, or due to triggered automaticity. (1)

🔪🔪 Killer ECG Patterns 🔪🔪

Part Two -- acute coronary occlusion.

litfl.com/killer-ecg-pat…

Deadly diagnoses not to miss when you are asked to quickly “sign off” an #ECG. A couple of things.

What about Wellen’s and ST elevation in aVR you say?

Crushing chest pain and diaphoresis.

The computer reads "inferior ischaemia"

You, the astute twitter-reading clinician, read "normal"

Here's why 👇🏾🧵

litfl.com/ecg-case-134 No, you are not smarter than a computer. But computers don’t allow for human error.

This ECG looks a bit odd. That should prompt us to shift to our system 2 thinking (systematic, conscious, analytical interpretation). (1/11)

Tox ECGs CAN be made easy 💊💊💊

Understanding these ECG changes make them easier to recognise 👇 @LITFLblog We may have heard that Na channel blockade causes “right axis deviation of the terminal QRS”.

But what does this actually mean? (1/13)