Thank you so much it is absolutely amazing video please make some more ECG videos about atrial tachycardia paroxysmal rhythm and if possible ICD and Pacemaker videos
When i take a deep breath and i hold it,i get premature atrial beats,atrial bigeminy and my av node exceeds my sa node so i get a junctional rhythm of 70-80 beats per @t stops as soon as i release my breath..Weird.I got this after my avnrt ablation.Never had it before the operation.I am trying to find out if it has something to do with the vagal tone..I dont know.. Any ideas?
Hello, Sir. Thanks so much for watching. I'm afraid I can't provide any medical opinion and would encourage you to reach out to your cardiologist directly. Thanks again for watching and take good care.
@@christouzeau8124 I've visited many doctors.Noone knows why i get this ! The only thing they not is that it is not dangerous ! I am sure this a side effect of the ablation which in some cases can have proarrhythmic properties.
A general question: is there any reference range for a normal T wave duration? I can kinda imagine how a "broad-based T-wave" looks like but if I had a value that'd be cool! And another question: The accelerated junctional rhythm is defined as having a ventricular rate >60bpm; I assume it's still slow enough to not confound it with other regular fast rhythms (not with A. fib + RVR since A. fib + RVR is still irregular, so pretty distinct; maybe a fast AVNRT/ orthodromic AVRT)? And finally, same issue: If you have many PJCs in a row with absent P waves, wouldn't it be pretty tough to make the DD with other regular fast rhythms?
The T wave duration will fluctuate based on the underlying rate. It would be reasonable to use 160 ms for the T wave duration for a rate of 60 bpm (100 - 250 ms range). You can differentiate accelerated junctional at a rate of 80, for example, and a sinus rhythm at a rate of 80, by the P wave. If the P wave is absent or inverted, it's a junctional, if it's upright, more likely to be sinus. Also, the PRI in junctional rhythms is shorter than in sinus. Thanks for watching.
Great question! Remember, the ECG can ONLY tell you about the heart's electrical activity and never about it's mechanical activity. The presence or absence of a P wave does not provide any information about atrial contraction (mechanical activity). The absence of P waves indicates there is no electrical activity from the SA nodal or atrial tissue. Bonus tip: remember that sometimes atrial activity can be hidden within another wave! For example, a P wave could be hidden in the QRS complex or less commonly in a T wave.
@@miaeba Great question. Sometimes seeing a longer strip is helpful to identify irregularity, especially in slower rhythms. Check out this video for a more detailed explanation of calculating rate - ua-cam.com/video/kwqMmtn8jbI/v-deo.html
Chris, Thank you for really taking the time to explain this. So far the best content I have come across.
As a new grad nurse, I am loving your channel! Was just hired on a telemetry floor and your EKG videos are so helpful. Thank you!!!
Thanks! This made junctional rhythms so much easier!
quite simple and very easy to follow! Thanks!
Thanks for this presentation. The terms PJC and Junctional Brady are new to me and know I understand them! Thanks!!!
Glad you like and thrilled to know this was helpful. Best of luck!
Love your content 🎉
Thank you so much it is absolutely amazing video please make some more ECG videos about atrial tachycardia paroxysmal rhythm and if possible ICD and Pacemaker videos
Thank you so much Chris very helpful
Man this guy is amazing here in 2024
It is soooo helpful. Thanks!
Great presentation ... thanx alot
GREAT !
Excellent work
I just wish you could measure the pr intervals and Qrs as opposed to their duration. Otherwise it's a really nice informative video
When i take a deep breath and i hold it,i get premature atrial beats,atrial bigeminy and my av node exceeds my sa node so i get a junctional rhythm of 70-80 beats per @t stops as soon as i release my breath..Weird.I got this after my avnrt ablation.Never had it before the operation.I am trying to find out if it has something to do with the vagal tone..I dont know.. Any ideas?
Hello, Sir. Thanks so much for watching. I'm afraid I can't provide any medical opinion and would encourage you to reach out to your cardiologist directly. Thanks again for watching and take good care.
@@christouzeau8124 I've visited many doctors.Noone knows why i get this ! The only thing they not is that it is not dangerous !
I am sure this a side effect of the ablation which in some cases can have proarrhythmic properties.
A general question: is there any reference range for a normal T wave duration? I can kinda imagine how a "broad-based T-wave" looks like but if I had a value that'd be cool!
And another question: The accelerated junctional rhythm is defined as having a ventricular rate >60bpm; I assume it's still slow enough to not confound it with other regular fast rhythms (not with A. fib + RVR since A. fib + RVR is still irregular, so pretty distinct; maybe a fast AVNRT/ orthodromic AVRT)?
And finally, same issue: If you have many PJCs in a row with absent P waves, wouldn't it be pretty tough to make the DD with other regular fast rhythms?
The T wave duration will fluctuate based on the underlying rate. It would be reasonable to use 160 ms for the T wave duration for a rate of 60 bpm (100 - 250 ms range).
You can differentiate accelerated junctional at a rate of 80, for example, and a sinus rhythm at a rate of 80, by the P wave. If the P wave is absent or inverted, it's a junctional, if it's upright, more likely to be sinus. Also, the PRI in junctional rhythms is shorter than in sinus. Thanks for watching.
Would the pjc count as bigeminy?
Yes, absolutely! As would PACs. Bigeminy simply means a pattern on the ECG where a normal beat is followed by an abnormal one.
Thank you Chris for taking the timeout to explain the content in such a way that it's easy to understand. Keep up the good work!
No p waves mean atria is not contracting?
Great question! Remember, the ECG can ONLY tell you about the heart's electrical activity and never about it's mechanical activity. The presence or absence of a P wave does not provide any information about atrial contraction (mechanical activity). The absence of P waves indicates there is no electrical activity from the SA nodal or atrial tissue. Bonus tip: remember that sometimes atrial activity can be hidden within another wave! For example, a P wave could be hidden in the QRS complex or less commonly in a T wave.
excellent
excellent!
junctional brady?? that is 60
Hello and thanks for watching. Junctional bradycardia is a junctional rhythm whose rate is less than 40.
@@Touzeau123 why choose strips longer than 6? I sorta wish you went over your rate method a bit.
@@miaeba Great question. Sometimes seeing a longer strip is helpful to identify irregularity, especially in slower rhythms. Check out this video for a more detailed explanation of calculating rate - ua-cam.com/video/kwqMmtn8jbI/v-deo.html
This is disugushtish
+Francisco Belisario Hello. Is there something specific you didn't like about the content? Thanks.