Rate and Rhythm | Supraventricular Tachycardia (SVT) and Wolff-Parkinson-White (WPW) Syndrome

[@ayseyurtsever2558]

It was always hard to understand ECG for me. But with you, it’s even fun and easy to understand. Thank you for the great explanation!

[@nickawilliams5175]

Thank you for the breakdown on WPW which is what I have. It was very easy to understand and I like that fact that you've included what to NOT give a person.

[@janisripple754]

Agree I have A WPW Variant- No ABCOr D

[@EnviedAbz]

Incredible explanations on your videos! I binge watched all of your ECG videos today because I'm studying for my finals and they're helping so much! Massive thanks and keep it up. PS. Just subscribed

[@macman6421]

It would of been good to show and ECG for pre exited atrial fibrillation. I had this and my ECG looked crazy. I had the ablation for WPW done 4 weeks ago and it seems to have been a success.

[@architasaha8917]

I am very much astonished with your skill and depth of knowledge. Thank you for your brilliant concept and teaching skil.

[@yasfakhraeian1907]

you are the best teacher I have ever had, thank you

[@isabelladelacruz553]

Thank you for discussing the medication portion and how it's important just to get rid of it all together with a radio frequency ablation. I have just found out I have wolff-parkinson-white syndrome, and I need to make a decision on what my course of action will be.

[@jjrockjon8610]

Who's here to get your WPW explained to you??? 🙋‍♀️

[@AmiHuynh1]

If you are here to learn about your WPW, make sure if you end up in the ER that you are NOT given Adenosine, it is contraindicated for WPW.

[@gcflupis]

Such easy to understand way of explaining!!! 🙏🏻🙏🏻🙏🏻 thanks a lot !!!

[@BakrAli10]

1. Rate: normal, tachycardia, bradycardia 2. Rhythm - R-R interval: regular, irregular (almost always a fib, multifocal atrial tachycardia, ectopic rhythm like some aberrant conduction like PAC PVC) - P wave: sinus (II +, aVR -)[if inverted: lead misplaced, dextrocardia, ectopic rhythm], ectopic (atrial ectopic rate > 60 abnormal p wave or retrograde), junctional (AV node rate 40-60 might be retrograde p wave too cause might be SA node damage), idioventricular (Purkinje fibers rate 20-40 looks like PVC also it might be accelerated to a rate of 60), if irregular and no distinguishable p wave look for fibrillatory waves in V1 or II then it's a fib. If not sure about II look at III avf, saw tooth abnormal p wave is atrial flutter F wave. No p wave (look for F waves of fibrillatory waves or flutter waves in II V1 III) - P -> QRS: AV association, heart block, AV dissociation (if no p wave then it is dissociation), Ratio of p to qrs 3:1 (dissociation) or 1:1 (association) - QRS: narrow, wide (VT, junctional rhythm, aberrant conduction down the bundle branch system) Tachycardia, regular, narrow: 3 things: ST, SVT, AFL How to distinguish between ST and SVT? Vagal maneuver (carotid massage, breath in a straw, valsalva maneuver to poop themselves), adenosine. SVT supraventricular tachycardia, could come from: 1. Ectopic atrial focus aka paroxysmal atrial tachycardia (generating reenterant circuit that continues to fire down the ventricles). 2. Or ectopic junctional focus aka paroxysmal junctional tachycardia (AV node generating reenterant circuit that continues to fire down the ventricles). If regular R-R, sinus p wave and wide QRS: take a look at the PR interval: short PR interval. + Delta wave + ST depression and T wave inversion It is WPW syndrome type A, aka AVRT (atrioventricular reentant tachycardia) which is a specific type of SVT Pathophysiology: cells between left atrium and left ventricle (Bundle of kent) conducts action potential down to the left ventricle earlier This causes Right axis deviation because the left ventricle has already depolerized earlier + Wide QRS So, pre excitation + RAD + wide QRS + delta wave Short PR interval Management: if someone has WPW syndrome (and especially if they have AF too): Remember ABCD 's (Adenosine, Beta blockers, calcium channel blockers, Digoxin) You NEVER give them these, because it will inhibit the AV node, resulting in the action potentials travelling mainly through the bundle of kent, and develop reenterant circuit that will quickly develop into VT or VF You give amiodarone or pocainamide. Or even better: radio frequency ablation

[@ayushgodhani7648]

Thank u so much sir!! But if possible can u make video for ecg of mi, lbbb, rbbb, and details of wpws

[@NeilArmstrong-x8f]

A true ECG god. What a superb teacher, I could watch and learn all day!

[@farahdeborah]

Thanks for all your wonderful video's you helped me so much. I made a little donation, I call it money well spent!

[@rahbar2002]

legend, you should be the president of medicine intergalactic

[@asadzaer9144]

Your lectures are excellent. Please more videos and if possible give more examples for each condition on on ECG strip.

[@saidasaid9565]

Thank you so much, your explanation is amazing!

[@sapolek]

Thank you so much for your enormous work, it is really huge, what you are doing there

[@tinakung01]

Thank you so much for EKG. If you make the big mark point cursor that the big wonderful guy 💜💜💜

[@MrChad1205]

Thank y’all some much! I learned some much from y’all, thank you!

[@addyb9374]

Thank you for explaining so well!

[@drnss21]

Excellent. You made it so clear

[@krishsathish3076]

i love the work u guys do. U guys have helped me a lot throughout the years. just a quick favor. Could you talk more about skeletal and integuementary. Skeletal, specifically the physiology of like functions as well as ossification

[@Zetsuke4]

Krish Sathish Yes

[@megamouth01]

Excellent lectures. Thanks so much

[@sofar6339]

now on I will give you a like even before watching the video

[@CommonMedicalNeeds]

too good and made it so easy to digest , thanks sir

[@monalisamidya1033]

What a explanation¡🙏🏻 Thank you so much 😀😀

[@angelathigpen1557]

Great lecture

[@ahc1957]

My son has WPW. I just had minor surgery with local anesthetic. I had three episodes of my heart rate suddenly going from 47 to 147 approx. my angels, the nurses were very frightened. No doctors in sight. The head nurse was the commanding officer. She was on the phone each time with the doctor explaining what to do. They gave me an injection and things started going back to normal. It almost made it to normal but then went up again, two more times. I felt terrible. Eventually a doctor came by, hours later when everything was over. He was not concerned and I wanted to know what happened. They have no answers. But they do tell me with all certainty that it was not WPW. I’m not convinced. The ECG was taken hours after when the episodes over. I really wish I could understand this. Is WPW really genetic or hereditary? How can I find out more or should I bother?

[@sewamazing4498]

It can be genetic but its not very common

[@r.i.a6485]

Thank you so much ❤️❤️

[@uvthewonder]

Pls make videos on Hyper, Hypo kalemia, hyper , hypo calcemia, Lbbb, Rbbb, Lvh, Rvh

[@gayathriliyanage6748]

Excellent Thank you dr

[@Borlingr]

Thank you for explaining!

[@ktj115]

IMO Best starting video series for establishing a SYSTEM mentally as we view and assess an ECG reading.

[@randihowey3680]

For the PCP's out there (you know who you are), we do not preform vagal maneuvers!!! (yet) That is an ACP skill ONLY. Calculate the heart rate. If it's over 165 BPM, it's SVT. Call for ALS back up and wait for them if they're close or diesel therapy to closest hospital.

[@zas881]

Thank you ❤️❤️❤️❤️ جزاك الله خير

[@venkatesanrenuka3957]

Thank you 😊

[@2013Queen]

Love this

[@rajeshshivaramaiah4581]

Hi , what would be the auscultation findings in wpw syndrome. Also what would be the symptoms.

[@isakmulla2423]

Thank you!!! Sir can u explain more about cardioversion plzz

[@gabifalcao4975]

Thank you!Very very very good

[@WatchoutNSG]

Thank you for this video, I am currently 22 and I was diagnosed with WPW 1 year ago and feel that it does not inhibit my daily life, the main reason why they tested my heartrate was because of me explaining how I have had moments where I felt my heartbeat raise and my vision blackout and the feeling on lightheadedness that lasts for 10-50 sec very rarely(2-4 times a year total), the reason that it was triggered was not due to me doing anything to overbearing, merely walking in a hot enviroment with no water for hours or working with my hands while standing after 4 or more hours also with no water. I am extremely hesitant to get the oblasion as I feel the diagnosis does not inhibit my life, but it potentially does more than I could be aware of since ive lived my entire life with this. Here are my questions: is this diagnosis able to be mis-interpreted? Is there any potential/rare consequence to getting the oblasion? is there any actual side effects that people have reported as a result of having WPW? Thank you for anyone to read this and Ninja for making the vid, ive done over a hundred hours of research and just can't bring myself to trust someone to do heat surgury to me and potentially inhibit my current normal/high functioning lifestyle.

[@petarmalesev8349]

You have spent hundreds of hours researching, I have spent 12 years, so listen carefully. Your blackouts are not the consequence of WPW or other arrhythmia, but of the dysautonomia. Your Autonomous Nervous System gets problems from time to time and influences how your heart works but also the level of BP, so you get lightheaded etc. No ablation will cure you, the main cause will remain. If you want more info, go to Dysautonomia International.

[@tapanthaker8005]

Wait till you get atrial fibrilation with wpw .. you will collapse so quickly you wont be able to write a comment like this .. get surgery

[@melodrama1401]

Tapan Thaker what are you talking about?

[@WatchoutNSG]

​@@macman6421 ​ Thank you for taking the time to explain your experience with this condition, I have still not gotten the ablasion and have had epsiodes where my heart rate starts spiking and having abnormal rhythm, it happens when im already hot and tired and after lifting something heavy a few times, after doing so If I miss an inhale of air, my heart will start beating faster till a take a big breath to compensate for the one I missed and ill get slightly dizy and if the heat doesnt stop I may eventually lose vision (it all goes black) and I feel lightheaded, this hasint happened in like a year. So if you could, please tell me what your life is like after a few months after the surgery, if you work out or lift heavy things tell me, is it easier? Do you feel as if you have more energy and stamina? These are the questions I need to know before I feel I need to get the surgery done, thank you friend and im happy you did what you believed needed to be done for your health.

[@janisripple754]

@@petarmalesev8349 thanks for this information.

[@Skipper767]

Highly appreciated

[@boatlover1875]

Kind of scary. Had WPW and an ablatlion at Mass General in Boston. Had What I was told was afib by the EMT in the ambulance, 220 bpm while at a training session in TX. Tried to give me an "av block" in the ambulance on the way to the hospital couldn't find a vein? This was in TX and went back to MA to see a doc. I was prescribed a beta blocker at the TX hospital, sounds like a bad plan from your video but all ended well.

[@giltuito1545]

thank you Sir, for the great videos. just one question to all of you: shouldnt adenosine decrease HR anyway, whether it is SVT or sinus tachycardia?

[@nygeek6471]

The point is to look for what rhythm comes when you slow the heart rate down.

[@YessBStrong]

Si helpful. Thank you

[@kaviyamurali5894]

Awesome..Thank you so much sir!!!!!

[@monalisamidya1033]

Can you please make a video on LBBB &RBBB...related diseases...😇

[@WONDIFRAWADMASU-cr8wl]

it is very interesting and always very complicating for me

[@erikruizmd]

what prgrom do you all think he uses for the illustrations ?

[@tarek6359]

So the last one was Antidromic WPW (because of the wide complex)? But it can also be a narrow complex WPW ?? (orthodromic)

[@bernardolaino950]

Isn’t wpw supposed to be left axis deviated?

[@ayushlal6198]

Thanks soo much

[@lietrelledennizsistona7135]

Hi, Good Day. I have a question and hoping to get an answer. How many boxes apart is considered as a short P-R interval? And how many boxes apart is considered normal? Thank you in advance.

[@2013Queen]

Normal is 0.12-0.20 or 3-5

[@salaheddinekniweer502]

Thanks

[@אהדהלוי-מ5ס]

how can you tell in the first ECG that's it's a T wave and not a P wave?

[@himanshumudgal8671]

We can see delta wave in lead 1 also at the top of qrs?

[@sofieelamine880]

thank you!!!

[@purushottamparajuli842]

Great👍👍

[@tinamariemcwilliams4692]

Thank you! So say Someone has Rbbb should the dr give them digoxin

[@animeokabekyouma4390]

Why is aVL qrs complex facing in negative direction

[@lukasx543]

Is not there a right axis deviation?

[@ASMR_AND_MORE_123]

qrs doesn't seem to be wide to me

[@morakabimotsei1470]

can we just administer adenosine without actually doing the manueuver ??

[@فاطمةقاسمعبدالباري]

When we calculate the rate , why we sometimes multiply by 6 and in other times by 10 ?

[@runayred]

If the page is 6 seconds strip you multiply by 10, if the page is 10 seconds strip you multiply by 6

[@katielewis1654]

As a WPW patient with two failed cardiac ablations under my belt, SVT and adenosine are no freaking joke!!!!! Adenosine gives you a severe case of impending doom sensation, you feel like you’re about to die!!!! Not fun at all

[@КлараЦ]

Я ваш коммент считаю лучшим под англоязычными роликами о наджелудочковых тахикардиях. Да, АТФ это маленькая смерть. Кроме аденозина колят ещё веропамил. Рча действительно не панацея, и помогает сомнительно и не всем. Весь мир в аритмиях и свт и авурт и wpw. И многих нарушениях ритма сердца. Почему-то мировая наука по сей день не может найти избавление от этой напасти. Мы сидим на конкор, фебриляции предасердия лечат более серьёзными препаратами. А обстановка в больницах на удивление очень похожа. Желаю Вам здоровья, хотя бы улучшения, и знайте, что вы не один такой человек.

[@Zetsuke4]

Awesome!

[@marlenarteaga3617]

SVT is the same as atrial tach right?

[@neginali5513]

Was it WPW type B? Please answer

[@Kez_abi]

Not a med student some one with a dodgy heart trying to understand their conditions. Wolff Parkinson White Cardiomyopathy Sinus Tachycardia Ventricular Pre-excitation Atrial Fibrillation Supraventricular tachycardia

[@noahmorris5494]

Cant atrial flutter be irregular?

[@Sriram-jl8ex]

Please increase your cursor size

[@doctor9410]

why you are multiplying R wave with 10 in lead 2 i m confused?

[@aslbekyuldoshev5264]

Awesome

[@rayana.ibrahim1344]

bravo ❤️

[@محمداحمد-ت1ل9ز]

Thank u

[@moley2006]

Why is it multiplied by 10?

[@Whit23ney]

Do vague maneuvers help this? I’ve tried them when my HR got to 241 during my stress test and it did NOTHING. Still waiting to see my cardiologist for further testing but I’m lost. My report had an inverted t wave and ST depression and was noted as possible anterior ischemia. I’m a marathon runner and went to the doctor because I get chest pain when I run now. 🤷‍♀️

[@2013Queen]

If you’re already experiencing ischemia and a past anterior MI, most likely the pain could be ischemia. Lack of blood flow is pain.

[@mohammedalbassam560]

Thx

[@patriciabong20]

thankyouuu

[@Mariam-nv1fk]

i didn't get why there is two rates one is 190 and 150 .

[@alexandruionut8553]

I have PAT due to some hormones since I was 16 and now im 22(usually 160bpm and diastolyc HT),it.s so stresfull because the anxiety starts it i dont know how to get rid of that or how to control my emotions(im extreeemely instable emotionaly). Any recomandations?

[@malinasuciu4378]

Counting from 1 to 10, deeply taking breath in and out or imagining everyone is naked? :) There s no given method, maybe it s only about giving yourself credit, trust your gut, allow yourself being vulnerable and imperfect, cause that makes us perfect :) You can, I do, believe in you!

[@MatanLinevitz]

תודהההההה

[@kurayC]

I have wpw . I was born with that (extra pathway) my problem is I have extrasystoles A.K.A Skipped heart Beat. Not everytime tho really weird my doctor Said WPW Not make a extrasystoles anda they dont wanna ablation to me I dont know why

[@seva00793]

nice

[@samuelpeterson7043]

"Mama JuJu dis is sinus" lmao

[@ma.gildamontilla346]

Please sell notes without subscription to us students looking for jobs

[@kamalbouder4575]

❤❤❤❤❤

[@khaoula7389]

thnx

[@rabiakulsum8891]

Raghib Asfak 😉

[@ucheohiri9678]

pointer tiny

[@Haideriyum718]

❤❤❤❤❤❤❤❤❤❤

[@nazri8302]

👍

[@SAM-ln6on]

MAMA JUJU

[@b.l219]

✔️👍🏻

[@benzino3044]

Someone help me im 26 i have this just found out cause my body went into cardiac arrest and now im so worried i need info please anyone anything will help me anything

[@memersharma1551]

DIP diet that can increase nitric oxide level in the body to regenerate your damaged tissue and lead a healthy life its naturopathy

[@muromomab]

Lamarcus Aldridge :(

[@HuxleySabrina-u8l]

Jackson Carol Martin Kenneth Hall Ruth

[@kasjopea95]

[@carolynhickson7960]

Thanks

[@NinjaNerdOfficial]

Thanks so much for the support!

[@sruthisaravanan1342]

Thank you 🥰