Cardio resident / ECG / Echo / POCUS and critical care
Berlin, Deutschland
Joined December 2017
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alexander degkwitz retweeted
Rapid atrial fibrillation is common in the ICU.
How do you decide whether Afib is driving hypotension or simply an innocent bystander?
A 🧵
(1/x)
alexander degkwitz retweeted
👇ECG and PAC/EAT Localization (Part 2): Anterior Atrium vs. Posterior Atrium👇
•P wave positive in lead aVR: Indicates that the PAC/AT likely originates from the anterior region of the atrium. This includes areas such as the tricuspid valve annulus, coronary sinus , mitral valve annulus, LAA, and septum.
•P wave negative in lead aVR: Indicates that the PAC/AT likely originates from the posterior region of the atrium. This includes structures such as the crista terminalis, near the sinus node, posterior wall, and pulmonary veins.
👉 #EPeeps The often-overlooked aVR lead should no longer be ignored! aVR covers a large region on its own and provides critical diagnostic information
This post was created in collaboration with @N_Trajkovska 🙏🙏
@Phiso_de @chris_sohns @MoneebKhalaph @MBraunEP @StephanWinnik @Cardioschool @VanessaSciacca_ @GNageler @BSCCardiology @AbbottNews @jjmt_ep @Medtronic @ALFIEEP1 @ecgrhythms @ecgandrhythmRoe @ECGEPSCADEVICE @Ecgloverr #CardioTwitter @syamkumarmd @pjsm83
alexander degkwitz retweeted
Here are my most important learnings and reflections as an intensivist in 2024.
A 🧵
alexander degkwitz retweeted
Excellent point Korbin.
Another reason I like to scan the IJ in conjunction with the IVC to assess CVP - can help make you aware of some of the common cofounders
xitter.gq/katiewiskar/status/185…
1/
#POCUS exam of both the internal jugular vein (the POCUS JVP 🤩) and the IVC can be used to estimate central venous pressure ✅
⁉️ BUT - what happens when these two scans are discordant?? 🫢
A quick #tweetorial 🧵on interpreting contradictory IVC and JVP results
alexander degkwitz retweeted
🧵1/Little I did know about Bachmann's Bundle (BB) before starting EP fellowship. Quick run👇
BB is the main pathway of electrical conduction between right & left atrium. BB is muscular bundle connecting right & left atrial walls.
❌Disruption of BB causes "Interatrial block"
#EPeeps #CardioTwitter
alexander degkwitz retweeted
100% agree. We need to support and celebrate #PROFID trial
We need to conduct new ICD trials in the current era of 4-pillar GDMT.
Revisiting ICD Therapy for Primary Prevention in Patients With Heart Failure and Reduced Ejection Fraction | JACC: Heart Failure jacc.org/doi/10.1016/j.jchf.…
alexander degkwitz retweeted
77y Male with very interesting Holter strip. What you think? @syamkumarmd @ecgandrhythmRoe @ecgrhythms @DidlakeDW @The_Nanashi_O @Arron_Pearce_ @DaveRichley @SergioPinski
alexander degkwitz retweeted
🎅 Am 06.12. gab es am @Vivantes Klinikum Am Urban in Berlin die Nikolaus-Neuauflage unseres Hands-On EP-Kurses „Hand-aufs-Herz“ –
✋➡️🫀
und was für ein Tag es war!
📚 Spannende Impulsvorträge zu den Grundlagen der Elektrophysiologie legten den perfekten Grundstein
💉 Intensive und abwechslungsreiche Live-Cases, die uns alle herausforderten und bereicherten.
🖐️ Simulator-Training: Von der transseptalen Punktion und Leistenpunktion bis zum Einsatz von Ablationskathetern konnten die Tielnehmenden ihre manuellen Skills unter Beweis stellen.
💬 Besonders begeistert hat uns der Austausch mit der Gruppe: Viele Diskussionen, wertvolle Fragen und ein beeindruckendes Engagement haben den Kurs zu einem echten Highlight gemacht.
🙏 Ein ❤️ Dankeschön an alle Teilnehmer:innen, Referent:innen und Unterstützer:innen die diesen Tag so besonders gemacht haben! Wir freuen uns schon jetzt auf die nächste Runde!
@laura_rottner @Medtronic @MDTVascular @burakduymaz
alexander degkwitz retweeted
ICU Resuscitation Thoughts:
Every 2 y this time of the year I have to provide my hospital-employer w proof of ACLS recertification. I usually take an on-line course which I finish in a few hours. Sadly, this biennial ritual is also a reminder that we keep following the same #CPR
alexander degkwitz retweeted
Ein toller Tag geht zu Ende … 🏁
🎅 #NikolausEdition Hand aufs Herz 2.0
✅ Spannende Fälle im EP-Labor
✅ Hands-On Training an Simulatoren
✅ Angeregte Diskussionen
Danke an alle Teilnehmer*innen u. das Rhythmus-Team der #VivantesKlinikAmUrban 🙏
@sebFeickert #medtronic
alexander degkwitz retweeted
All you need to know about Typical Atrial Flutter as #YoungestDGK and @YoungDgk !
#EP_Kiel @evgeny_lyan @sebFeickert @laura_rottner @ChristianHeeger @DavidDuncker @Hannah_Billig_ @Kardiophil @BerkanKurtMD @HenrikeHillmann @narrowQRS @HubrichtD @melhamriti @LuisEichelmann
alexander degkwitz retweeted
Do you routinely measure #MAPSE?
Did you know that MAPSE beats #GLS and #LVEF regarding prognosis?
A new multicenter collab study out, led by @KellmanPeter
Ref: pubmed.gov/35132872
#WhyCMR 🫀🧲 #EchoFirst 🫀🔊
A thread 🧵. 1/n
alexander degkwitz retweeted
#echofirst LV EF is central parameter in patient evaluation and decision making, but so many pitfalls to consider
👉 correct border detection
👉 go for #UEA
👉 avoid foreshortening
👉 take a look at your derived volumes
👉 go for quality or lets call it plausibility by looking at forward SV in LVOT and RVOT
alexander degkwitz retweeted
I was sent this ECG — and told that providers thought that the rhythm was 3rd-degree (ie, complete) AV block. — Do YOU agree? — GO TO — tinyurl.com/KG-Blog-458 —#ECG - #ECG_Ken_Grauer - #EKG — :)
alexander degkwitz retweeted
Auf Wunsch von @andreaskardio (der direkt die richtige Diagnose gestellt hat)
Palpitationen, 50mm/s
Pat w/ DDD-PM for AVB II°, Holter for screening of Afib.
Dont understand why PM is pacing here at this intervall (red arrows)..can anyone help?
If there is a tracked P-wave hidden in T - why is AVI so long? (UTR 120/min I suppose)
@ecgandrhythmRoe @ecgrhythms @EcgOxford #EPeeps
alexander degkwitz retweeted
As usually, great case by @EM_RESUS! Pls see how TEE i) revealed immediately the cause of the arrest & ii) showed chest compressions were ineffective because they were delivered over the LVOT
We do have a trial now in abstract form 👇 that studied the effect of TEE-guided CPR
Here's a video I made breaking down this Cardiac Arrest Echo that was recorded during CPR
#FOAMed
Need help: what is this? I think it’s 2nd degree Type 2 AV-Block because there is intermittent Av conduction (then RR Intervall is shorter) + escape, but some p waves w/ long PR should be able to conduct but do not?!
Can someone make a laddergramm?
@ecgandrhythmRoe @ecgrhythms
update: 24h holter with exemplary pictures (cave: misnomers on top of the tracings!)
- No Pauses
- max HF 74/min.
- Max Brady 32/min @ night
- 1:1 conduction
- clear wenckebach patterns
- high degree (like initial ecg) @ night
-> no sympt = no PM
@KostekMilan
alexander degkwitz retweeted
👇ECG and PVC: Differentiating Right and Left Bundle Branch Blocks for PVC Localization👇
👉 A PVC with LBBB pattern originates from the right ventricle.
👉 A PVC with RBBB pattern originates from the left ventricle.
@Phiso_de @chris_sohns @MBraunEP @MoneebKhalaph @VanessaSciacca_ @Cardioschool @ecgrhythms @ECGEPSCADEVICE @AbbottNews @jjmt_ep @BSCCardiology @Medtronic #EPeeps #CardioTwitter @YoungDgk @AGEP_DGK @StephanWinnik @AleSpoken