An EP tracing of a patient with arrhythmia is shown.

What is the beat encircled?

A 70 y/o man with left upper quadrant and hemothorax pain from last night 

He had performed EVAR last year due to Abdominal Aorta Aneurysm

Bp:100/70 PR:100/min  RR:18  Room air O2 sat:94%

WBC:12700 PMN 78% Hb:6.7 PLT:177000

Cr:1.7, Negative Tn

Abdominopelvic CT with IV contrast was done

What is your diagnosis and treatment?

A young lady came with palpitations, she had a previous session of RF ablation 6 years ago for WPW. ECG is shown.

According to the ECG, what is the diagnosis?

A middle-aged patient came to ED for an ICD shock. The tracing of shock delivery is shown:

what is your interpretation?

An 82-year-old lady came to the ER with the chief complaint of palpitation, she denied any complaints of dyspnea and chest pain, and her past medical history was remarkable for Dual chamber pacemaker implantation 6 months ago due to complete AV block.

what is the best next step ?

A 43-year-old  gentleman with a known case of Apical HCM underwent 48-h ECG holter monitoring for SCD risk stratification.

Below is one shot from his ECG Holter Monitoring :

Which one is the best next step?

A 79-year-old man with a history of complete heart block and pacemaker implantation in 2020 without coronary artery evaluation. He is currently hospitalized with NSTEMI and is a candidate for coronary angiography.

According to the following ECG strip (Figure 1), what is the most probable diagnosis?

A young patient with narrow complex tachycardia underwent EPS, An EP tracing is shown below.

What is NOT seen in EP tracing?

A 31 years old woman presented with paroxysmal palpitation.here there is her ECG Holter.

Which statement is NOT correct?

A 60y/o man with a history of coronary artery disease and heart failure with EF=15% came to ED complaining of palpitation.ECG of tachyarrhythmia and previous ECG in sinus rhythm are shown:

What is your most likely diagnosis?

A 70 years old patient with history of prostate cancer, taking Abiraterone and Bicalutamide and Motoprolol came to ED with complaints of dizzy spell and snoring with convulsive movement especially when asleep.

Two ECGs are shown:

What are you going to do?

A 66-year-old woman presented to our emergency department with acute onset of chest pain and dyspnea that had started 6 h earlier.  BP = 120/70 mm Hg, HR=113 beats/min, RR 26/min.  O2 saturation 92% in room air. She had a coronary angiography the day before arrival. Twelve lead ECG and Right-sided ECG and Angiography shots of RCA are shown.

What is the most likely diagnosis?

A 78 year old lady with history of diabetes mellitus, hypertension, heart failure (ejection fraction about 30 percent), COPD and no documented history of arrhythmia has been admitted due to combined COPD exacerbation and decompensated heart failure. baseline ECG is shown below. after 3 days of admission she experienced palpitation and ECG during palpitation is also shown.

What is the most correct diagnosis and management?

A 57-year-old man is transferred by EMS during the night with persistent chest pain since the afternoon to the emergency department of a non–PCI-capable hospital, located 3 hours away from the nearest PCI center.

Past Medical History:

• Diabetes mellitus (DM)

• Hypertension (HTN)

• Hyperlipidemia (HLP)

• Cigarette smoker (CS)

• Opium addict (OA)

• Previous intracranial hemorrhage (ICH)

Assessment on Arrival:

• Vital signs: HR 90 bpm, BP 85/55 mmHg

Based on the patient’s condition, what is the most appropriate next step in management?

A middle-aged patient with a history of atrial septal defect (ASD) repair underwent an electrophysiology study (EPS) with Precision. Below, you can find the propagation and sparkle map.

What is the most probable mechanism of arrhythmia? 

Below you can find 3D mapping and EP signals of a case of VT ablation: 

What statement is wrong in this case?

A patient with Dual chamber ICD came for analysis, below you can find analysis tracing and chest X-ray.

According to analysis and chest x-ray, what is the probable diagnosis?

A 67-year-old male patient with a history of diabetes and hypertension came to our clinic with the chief complaint of DOE FCII from 3 months ago

His ECG is shown below

Echo: EF: 50 %, SPAP: 55,  Severe LVH, Diastolic Dysfunction Grade III, biatrial enlargement

CMR: RCM, Cardiac amyloidosis should be considered

We ordered Protein Electrophoresis with immunofixation which result is shown below :

M peak : 3.1 g/dl ( normal range < 3 g/dl )

What is the best next step?

A 41 y/o female patient with AKI on CKD, experienced  a sudden episode of palpitation and chest pain afterwards. The episode lasted for 10 minutes and ended spontaneously. She also recalled an episode of syncope 2 months ago. 2 weeks ago her brother died suddenly at the age of 37.

Below you can find her ECG.

Which one is not your choice?

A 68 y/o woman (wt=62 kg) came to the hospital with a chief complaint of palpitations and chest pain. Two weeks earlier, she underwent PCI procedure due to STEMI and she was receiving ASA 80 mg daily and Ticagrelor 90 mg BID. In laboratory findings, SrCr was 2.1 mg/dL and her ECG revealed atrial fibrillation. 

What is the most appropriate antithrombotic regimen for this patient during the first year after PCI?