When not to anticoagulate “A. fib”
Episode 20
January 22, 2012

What’s the most inappropriately-overdiagnosed dysrhythmia in medicine? And how can this misdiagnosis lead to iatrogenic hemorrhage? Learn from this case and never screw this up yourself. Give 10 minutes of your time to this video and you’ll have the answers. 

 
Both physicians and ECG machines tend to over-call atrial fibrillation. This leads to patients being anticoagulated inappropriately and can cause bad outcomes.
 
If the rhythm is REGULARLY irregular, it’s not atrial fibrillation!
Two important causes of regularly irregular grouped or “clumped” beats
  1. Premature contractions - cause pauses after clumped conduction
    • Clumps of 2 ? Think atrial bigeminy
    • Clumps of 3 ? Think atrial trigeminy
  2. 2nd Degree AV Blocks
    • Mobitz I - Progressive PR-interval lengthening then a dropped beat.
    • Mobitz II - Some but not all impulses are transmitted without progressive PR-interval lengthening

When not to anticoagulate “A. fib”
Episode 20
January 22, 2012

What’s the most inappropriately-overdiagnosed dysrhythmia in medicine? And how can this misdiagnosis lead to iatrogenic hemorrhage? Learn from this case and never screw this up yourself. Give 10 minutes of your time to this video and you’ll have the answers. 

 
Both physicians and ECG machines tend to over-call atrial fibrillation. This leads to patients being anticoagulated inappropriately and can cause bad outcomes.
 
If the rhythm is REGULARLY irregular, it’s not atrial fibrillation!
Two important causes of regularly irregular grouped or “clumped” beats
  1. Premature contractions - cause pauses after clumped conduction
    • Clumps of 2 ? Think atrial bigeminy
    • Clumps of 3 ? Think atrial trigeminy
  2. 2nd Degree AV Blocks
    • Mobitz I - Progressive PR-interval lengthening then a dropped beat.
    • Mobitz II - Some but not all impulses are transmitted without progressive PR-interval lengthening

  1. old-ekgumem posted this
Short URL for this post: https://tmblr.co/Zls-wvGjuA0r