Jim Palmer

Nurse Practitioner in EP since the Stone Age. Lover of EKGs

[Jim Palmer @JimLascivious]

@chris_monkhouse Ya. I agree. First blush was AVNRT based on onset. Didn’t look closely enough. AT makes more sense given A driving V and VA interval not fixed. Thanks !

[Jim Palmer @JimLascivious]

@chris_monkhouse Based on initiation I would say AVNRT

[Jim Palmer @JimLascivious]

@Ecgloverr @kodirov_md Exactly

[Jim Palmer @JimLascivious]

@kodirov_md @Frances98392343 That’s NSR with PACs and PVCs. PVC location with very early transition, + inferior leads and + lead I points to possible RCC (agree with Pedram)

[Jim Palmer @JimLascivious]

@PrecordialSwirl @KostekMilan @ekgpress @PPodrid @syamkumarmd @Frances98392343 Initiating PVC with retrograde atrial activation, AV nodal echo and then initiation of AVNRT. That’s my take. Looks like a horse, not a zebra.

[Jim Palmer @JimLascivious]

@USMLERounds And PR segment elevation in aVR

[Jim Palmer @JimLascivious]

@sumitvermaep Ablating the blocked PAC would be ideal. Sometimes not feasible.

[Jim Palmer @JimLascivious]

@TrackYourHeart Depends what your goal is. If you want VF. Do a stress test

[Jim Palmer @JimLascivious]

@Ecgloverr @AThomazAndrade @DaveRichley @ecgandrhythmRoe @ecgrhythms @Hapa_EP @josecruz2102 @ProfDConnelly @syamkumarmd @GusCostaEP57 @Koichi16423232 Convex STs concern for acute MI. Two strips different parts of the day, difference in autonomic tone for A rate difference ? High grade AV block. Might need a heart Cath and temp pacing

[Jim Palmer @JimLascivious]

@TrackYourHeart Left Anterolateral AP in preexcited AF? I think that’s right.

[Jim Palmer @JimLascivious]

@Frances98392343 Makes sense

[Jim Palmer @JimLascivious]

@Frances98392343 So true

[Jim Palmer @JimLascivious]

@Frances98392343 Got it. Awesome

[Jim Palmer @JimLascivious]

@Frances98392343 Nice. In EP?

[Jim Palmer @JimLascivious]

@Frances98392343 Agree. What do you do? MD?

[Jim Palmer @JimLascivious]

@Frances98392343 You were. I think you are spot on

[Jim Palmer @JimLascivious]

@HunterBiden @JeremyRudy Very well said. I appreciate your perspective here. I need to look into the trials on these therapies more thoroughly.

[Jim Palmer @JimLascivious]

@Frances98392343 @nadig_cardio I think it’s 110 am for Medtronic and maybe 120 for Bost Sci? Can’t remember all the different companies

[Jim Palmer @JimLascivious]

@Frances98392343 @nadig_cardio Correct. That’s my guess. How else do you get two pacing spikes with that CL. Right ? I’m at a party now so can’t really scrutinize closely. That was my 30 second look guess!