70 years old patient with a history of dual chamber pacemaker implantation 5 years ago presented by device malfunction (no pacing), device analysis performed.

Based on the report of programming and chest x-ray which problem is unlikely?

54 years old lady with history of dual chamber pacemaker implantation presented by dizziness and syncope.

look at ECG, Chest Xray , and device programming:

According to findings what is the best explanation for device malfunction?

A 39-year-old man was brought to the emergency department by ambulance with presentation of sudden and complete LOC.

Basic life support was perform before arrival at the hospital. Cardiac monitoring showed ventricular fibrilation and patient recieved defibrilation then pulse became detectable. The first ECG which was taken 3minutes after DC shock is shown below.

Which of the statments presented here is true about this patient?

Below you can find the ECG of arrhythmia and CS venogram during RF ablation.

Where is the ablation catheter and what was the target of ablation?

A 65 years old man with recurrent palpitation, underwent EPS, Two EP tracings are shown:

What is the most probable diagnosis of the Arrhythmia?

A young man was referred to the ED after experiencing syncope during exercise. He was unresponsive upon arrival. Below are the ECGs obtained during resuscitation and at rest.

What is the most probable diagnosis?

A 50 years old lady with history of unsuccessful RF ablation underwent EP, Arrhythmia was easily inducible with programmed stimulation, below you can see surface ECG, Entrainment maneuver and also 3D mapping with precision:

What is the mechanism of arrhythmia?

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?

Below You can find an EP tracing  AFTER the ablation of a patient with orthodromic AVRT.

What is your interpretation?

A 60-year-old lady with the complaint of syncope, two ECGs are shown:

which statement is FALSE?

A 34 y/o man came to ED complaining of retrosternal chest pain  which was started 2 hours ago & lasted one hour .He was mentioned an episode of heavy weight lifting the day before. He had no known coronary artery disease risk factor in his past medical history.

two sets of troponin was sent:

1st hs-cTnT=80 ng/L(upper limit<24 ng/l)

2nd hs-cTnT=84 ng/L(upper limit<24 ng/l)

so he was undergone coronary angiography with diagnosis of NSTEMI

what is your most likely diagnosis for this patient?

Below you can find BP recording of a patient during EP study for SVT.

which statement is wrong?

A 62-year-old male with a history of diabetes and hypertension presented to the clinic with a chief complaint of atypical chest pain persisting for the past 6 months. The physician decided to perform a myocardial perfusion imaging (MPI) scan with adenosine for him. Following adenosine injection, the patient experienced palpitations and dizziness. Below are the ECGs depicting the arrhythmia and sinus rhythm.

What is the most appropriate diagnosis and what is the plan?

A 39-year-old lady with frequent palpitation, you can find ECG and EP tracings. 

What is the most probable diagnosis?

50 y/o man with history of dual chamber pacemaker implantation 7 years ago came to your clinic for routine checkup. He didn’t have any specific symptom.ECG was shown:

What is the most likely diagnosis?

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? 

A 72‑year‑old woman with a history of type 2 diabetes mellitus, ischemic heart disease, and end-stage renal disease on routine hemodialysis presents to the emergency department with malaise, generalized weakness, and nausea since last night.

On arrival:

• Blood pressure: 100/60 mmHg

• Pulse: 26 bpm, regular

• She appears fatigued but arousable.

Her ECG is provided.

What is the most appropriate immediate next step in management?

A middle-aged patient with frequent PVC underwent EPS and ablation.

Based on 12 lead ECG which statement is NOT true?

92 y/o frail man presented with unexplained syncope when sitting and also in supine position. LVEF=50%

ECG is shown.

What is your plan for the patient?

A 40 y/o woman came to your clinic for evaluation of chest pain. She claimed that she suffer from exertional chest pain for many years.

what is your diagnosis?