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EKG of the Week

EKG of the Week. 1/22/2014. Brugada patterns. http://thetornosnetwork.blogspot.com/2011/05/brugada-syndrome.html. Brugada Syndrome. Brugada pattern plus on or more criteria: a) Documented ventricular fibrillation b ) Self-terminating polymorphic VT

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EKG of the Week

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  1. EKG of the Week 1/22/2014

  2. Brugada patterns http://thetornosnetwork.blogspot.com/2011/05/brugada-syndrome.html

  3. Brugada Syndrome • Brugada pattern plus on or more criteria: a) Documented ventricular fibrillation b) Self-terminating polymorphic VT c) Family history of sudden cardiac death at <45 years d) Type 1 ST segment elevation in family members e) Electrophysiologicinducibility of VT f) Unexplained syncope suggestive of a tachyarrhythmia g) Nocturnal agonal respiration

  4. Right bundle branch block

  5. Last week: 44 year old man with history of alcohol abuse

  6. Osborne Waves Slows all conduction (RR, PR, QRS, QT) Osborne Wave height relates to degree of hypothermia (classically most prominent in leads V2 to V5) Resuscitation is not terminated until core reaches 32-35 degrees UpToDate

  7. Take Home Points: • General: • Abnormal QRS in V1 (also V2, V3) • Prolonged QRS and R-prime, can represent RBBB or Brugada • Osborne waves represent slowed conduction but not the bundle branch block of RBBB or repolarization abnormality of Brugada • This ECG: • Appears to be Brugada type I • Non-saddleback • Most concerning of Brugada patterns

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