Thank you very much for your great explanation and nice video, Dr. Nick Tullo! By the way, please share with us what apps, or softwares that help you to draw the notes, the lines, etc in your video, and we did not see your fingers to hold a pen? Thanks and you have a great weekend! We are looking forwards to seeing more your great videos and knowledge.
@@swerteko7737 Yes, it is. Think of it as two separate structures, doing different things. You just have to be careful to not label a strip as "second degree AV block" when in reality there are blocked PACs... in the latter example, the blocked p-wave comes early. In second degree AVB, strictly speaking, the blocked p-waves should be on time.
I got all set up for a basic exercise stress test today. I didn't even get one step on the treadmill and the Cardiologist came in, introduced himself and then told me we needed to proceed to a radioactive stress test due to my baseline. Now I"m very nervous. I push myself regularly and enjoy working out but have been off the last couple of weeks. Hummm!
Hi, Mercedes --- "Regular" treadmill stress tests are most useful in people who have totally normal ECG to start with. If you happen to have some abnormalities already, then it becomes more difficult to look for changes in the ECG that would indicate a problem like a coronary blockage. That may be why the cardiologist recommended a nuclear stress test, because the pictures of the blood flow to the heart are much more accurate to pick up blockages than the ECG. Besides, sometimes the ECG will change dramatically but the pictures look okay, in which case you usually don't have to pursue the problem further unless you are having recurrent problems like exertional chest pain. Hope that helps! -- "Dr. Nick"
Hi Dr Tullo, thank you so much for the great videos, I recently discovered and have had a great time going through them! I had a couple questions regarding this strip, hoping you could clarify. Would it be possible that the patient had 2:1 Wenckebach conduction both at the beginning and end of the strip and that the 1:1 conduction in the middle represents, for example, a period of relatively decreased vagal tone with re-establishment of 1:1 AV conduction? I understand that typically you use the rhythm strip in 2:1 block to identify periods of 3:2 or 4:3 block that might suggest Wenckebach conduction instead of Mobitz II, but will this always be the case/be infallible? Would you use clues such as no 1 degree AVB or presence of IVCD to suggest Mobitz II instead? I also didn't quite understand why you said that this is more likely to be Mobitz II block @3:55 because of a constant P-P interval; isn't this the case with both 2:1 Wenckebach and 2:1 Mobitz II? Finally I had previously learned that high-grade block was 3:1 or higher conduction blocks, is that inaccurate or is there disagreement in the EP community on which degree of block warrants PPM?
Thank you all for your positive comments!
Thank you very much for your great explanation and nice video, Dr. Nick Tullo!
By the way, please share with us what apps, or softwares that help you to draw the notes, the lines, etc in your video, and we did not see your fingers to hold a pen?
Thanks and you have a great weekend!
We are looking forwards to seeing more your great videos and knowledge.
@@ddll4012 I use a drawing tablet in Photoshop. And a bit of magic... :-)
@@ECGDoc Thank you, Dr. Nick Tullo! Please share a little bit more about "your magic". I really want to learn. Thanks. Hehehe
I have a question. Is it possible to have PACs in 2nd AVB?
@@swerteko7737 Yes, it is. Think of it as two separate structures, doing different things. You just have to be careful to not label a strip as "second degree AV block" when in reality there are blocked PACs... in the latter example, the blocked p-wave comes early. In second degree AVB, strictly speaking, the blocked p-waves should be on time.
Dr NICK is BACK!!!!
Love when you’re posting videos! Thank you.
Excellent, thanks 🙏🏽
He is back. Yesssss
Thanks a lot for interesting ECG. Great Explanation :)
Thanks for videos. 🙋♂️🇹🇷
I got all set up for a basic exercise stress test today. I didn't even get one step on the treadmill and the Cardiologist came in, introduced himself and then told me we needed to proceed to a radioactive stress test due to my baseline. Now I"m very nervous. I push myself regularly and enjoy working out but have been off the last couple of weeks. Hummm!
Hi, Mercedes --- "Regular" treadmill stress tests are most useful in people who have totally normal ECG to start with. If you happen to have some abnormalities already, then it becomes more difficult to look for changes in the ECG that would indicate a problem like a coronary blockage. That may be why the cardiologist recommended a nuclear stress test, because the pictures of the blood flow to the heart are much more accurate to pick up blockages than the ECG. Besides, sometimes the ECG will change dramatically but the pictures look okay, in which case you usually don't have to pursue the problem further unless you are having recurrent problems like exertional chest pain.
Hope that helps! -- "Dr. Nick"
@@ECGDoc Thank you for your response! 🙏
Thank you
Hi Dr Tullo, thank you so much for the great videos, I recently discovered and have had a great time going through them! I had a couple questions regarding this strip, hoping you could clarify.
Would it be possible that the patient had 2:1 Wenckebach conduction both at the beginning and end of the strip and that the 1:1 conduction in the middle represents, for example, a period of relatively decreased vagal tone with re-establishment of 1:1 AV conduction? I understand that typically you use the rhythm strip in 2:1 block to identify periods of 3:2 or 4:3 block that might suggest Wenckebach conduction instead of Mobitz II, but will this always be the case/be infallible? Would you use clues such as no 1 degree AVB or presence of IVCD to suggest Mobitz II instead?
I also didn't quite understand why you said that this is more likely to be Mobitz II block @3:55 because of a constant P-P interval; isn't this the case with both 2:1 Wenckebach and 2:1 Mobitz II?
Finally I had previously learned that high-grade block was 3:1 or higher conduction blocks, is that inaccurate or is there disagreement in the EP community on which degree of block warrants PPM?
Thank you sir for this strip
You're welcome!