ECG Quiz from Gulf and Saudi Conference 2013

Collected by Professor Samir Rafla Alexandria University smrafla@hotmail.com

(Attended the conference)

Answer follows each ECG

• WPWs

• Right posterior

• EPS to ablate

• Long QT

• Start BB

• EP study, if sustained V tach. is inducible implant ICD. If not inducible give amiodarone.

• Catecholaminergic arrhythmia. Start Beta blockers and amiodarone.

• ICD in this 13 y boy is second option.

• Short QT with high take off, incomplete RBB.

• Leave him alone, no intervention or drugs.

• Short QT is said to be present if QT is < 360 ms

• Pacemaker induced cardiomyopathy

• Upgrade to CRT

• Brugada syndrome

• ICD is the prober management.

• High take-off (LII), short QT

• ICD is indicated

• Short QT

• Start amiodarone.

• The answer is evident, the lead is broken and induces inappropriate shocks. Immediately magnet is put on the ICD to stop its function till lead is changed.

• ICD Lead fracture is one of the causes of inappropriate shocks. Other causes as pacemaker program misinterpret sinus tachycardia or AF as VT

• Recording from ICD memory prove that there was no VF and the shock was given inappropriately.

• The diagnosis is pericarditis: evidence is diffuse ST elevation, PR depressed.

• Start high dose of aspirin and follow up.

• Brugada syndrome

• ICD is mandatory as he got VF

• Early repolarization.

• No intervention or evaluation.

• Long QT

• Non of the above.

• Arrhythmogenic RV dysplasia, notice the epsilon wave in V1.

• Ablation of arrhythmogenic focus in RV outflow is needed. Recurrence is expected and redo ablation is to be done.

• Extensive anterior MI