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75 yo man with lightheadedness

Posted Oct 16 2013 11:37am
Episode 101
August 5, 2013
What’s the most over-diagnosed tachydysrhythmia? Know your “money lead” and you won’t make that mistake!
 
Be wary of diagnosing “atrial fibrillation”!
Never trust the ECG machine’s read & look carefully at every single lead!
 
    Both physicians and ECG machines tend to over-call atrial fibrillationThis leads to patients being anticoagulated inappropriately and may cause bad outcomesAlways scrutinize lead V1 (closest to the sinus node) for P-wavesAtrial fibrillation should produce an IRREGULARLY irregular ventricular responseIf the rhythm is REGULARLY irregular and you have grouped or “clumped” beats, consider second degree AV blocks (Mobitz I and Mobitz II)
For further review of AV Blocks watch this previous episode… Rhythm interpretation and diagnosis of AV Blocks For more on p-waves & clumped beats watch… If it’s REGULARLY irregular, it’s not atrial fibrillation!  
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