Syamkumar
@syamkumarmd
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Associate Professor, Cardiologist,Cardiac EP. Lifelong learner, Humanity and Science have no borders.Vital values: Humility and compassion
Hamilton, Ontario
Joined September 2015
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Double trouble! Patient admitted with recurrent syncope
#EPeeps
#CardioTwitter
#MedTwitter
@EPeeps_Bot
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Young man presenting to ER with ongoing palpitations for the last 2 days.
#EPeeps
#CardioTwitter
@EPeeps_Bot
@CHRS_SCR
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#EPeeps
#EPFellows
. AN interesting ECG to ponder about
What is going on here?
@EPeeps_Bot
@NimaZamiri
@GhaithAlmidani
@dog_oculus
@laura_goodliffe
@CHRS_SCR
@UlhasDr
@adribaran
@MattMelcherPA
@MaruanCarlos
@DidlakeDW
@brun_dav
@mahishasur
@DrRajeshG1
@bishoydf
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Syncope in bradycardia may not always be related to slow rates. What is triggering syncopal rhythm here?
#EPeeps
@EPeeps_Bot
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Medical students and trainees, what is the diagnosis here? Ashman or PVC? Why?
#ECG
#Cardiotwitter
#MedTwitter
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An interesting ECG from my archives for ECG aficionados. What is the most likely explanation?
#EPeeps
#CardioTwitter
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ECG for beginners. Describe the conduction pattern.
#EPeeps
#CardioTwitter
#MedTwitter
#ECG
@EPeeps_Bot
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An ECG for trainees and ACG aficionados. What is going on here?
#EPeeps
#FOAMed
#CardioEd
@EPeeps_Bot
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A bird in hand or two in the bush? Young man coming to ER with palpitation and post cardio version. What is going on?
#EPeeps
#ECG
@EPeeps_Bot
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An ECG for beginners. What is the reason for the group beating here? What is the diagnosis?
#ECG
#CardioTwitter
#epeeps
@EPeeps_Bot
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Bigemini again! what is the diagnosis ?
#Fellowsfirst
#FOAMed
#CardioTwitter
#MedTwitter
@EPeeps_Bot
@PMcardioBot
14
28
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An interesting ECG for trainees to describe! What type of AV conduction abnormality is this?
#EPeeps
#Cardiotwitter
#Fellowsfirst
@EPeeps_Bot
@ecgrhythms
@ECGfan
@ECG_Emily
@ecgoxford
@laura_goodliffe
@mahishasur
@GhaithAlmidani
@yaS0_0Ser
@UlhasDr
@MartowMartow
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#EPfellows
#Cardiologyfellows
What is the mechanism of this tachycardia? How is it terminated?
@EPeeps_Bot
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Medical students and trainees, what do you see here?
#EPeeps
#Cardiotwitter
#MedTwitter
@EPeeps_Bot
@ECGfan
@ecgrhythms
@EcgOxford
@DidlakeDW
@laura_goodliffe
@McMasterU
@CHRS_SCR
@McMasterIntMed
@UlhasDr
@DrRajeshG1
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Describe this conduction problem. An ECg for cardiology and EP trainees.😊.
#EPeeps
#CardioTwitter
#ECG
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Failure of AVNRT is a rare and frustrating .Left sided approach guided by the resetting maneuver elegantly shown by Dr Jackman might help is most cases where a right sided SP ablation fail.
@EPeeps_Bot
@dog_oculus
@NimaZamiri
@UlhasDr
@bordistef
@ShaojieChen1
@MattMelcherPA
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Young female found unresponsive and brought to ER. case of Yew berry poisoning! suicidal
#EPeeps
@EPeeps_Bot
@ecgrhythms
@ECGfan
@EcgOxford
@CHRS_SCR
@McMasterIntMed
@UlhasDr
@adribaran
@DidlakeDW
@MattMelcherPA
@bishoydf
@dog_oculus
@DrRajeshG1
@laura_goodliffe
@GhaithAlmidani
12
31
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One of the largest epsilon waves I have ever seen!
#EPeeps
@EPeeps_Bot
@UlhasDr
@adribaran
@ECG_Emily
@ELabartkava
@NimaZamiri
@plantain_bender
@ecgrhythms
7
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ECG for beginners and experts
What is the most likely diagnosis?
#EPeeps
@EPeeps_Bot
@BotCardiology
@NimaZamiri
@GhaithAlmidani
@dog_oculus
@laura_goodliffe
@ecgrhythms
@UlhasDr
@mahishasur
@adribaran
@DidlakeDW
@MaruanCarlos
@MattMelcherPA
@ALFIEEP1
@Doc_AleCuesta
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#EPeeps
, mid 50's patient presenting with palpitations in the ER. What is the most likely diagnosis?
@EPeeps_Bot
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An ECG for medical students. For the purpose of building core concepts in ECG. Diagnosis?
#MedTwitter
#FOAMed
#CardioTwitter
#ECG
@EPeeps_Bot
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An interesting ECG for trainees and ECG aficionados. Thanks
@NimaZamiri
for showing me this .How to explain this pattern?
#EPeeps
#Fellowsfirst
@GhaithAlmidani
@laura_goodliffe
@ecgrhythms
@ECGfan
@adribaran
@UlhasDr
@EPeeps_Bot
@MaruanCarlos
@DidlakeDW
@CHRS_SCR
@McMasterIntMed
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Likely mechanism of this tachycardia?
An ECG for Internal medicine/Cardiology trainees
#MedTwitter
#CardioTwitter
#EPeeps
@PMcardioBot
@EPeeps_Bot
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25
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An ECG for Trainees. What is going on here? How to describe the rhythm?
#EPeeps
@EPeeps_Bot
@NimaZamiri
@GhaithAlmidani
@dog_oculus
@laura_goodliffe
@adribaran
@UlhasDr
@CHRS_SCR
@SignalstEPh
@MattMelcherPA
@DidlakeDW
@MaruanCarlos
@Doc_AleCuesta
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Trainees and ECG lovers, here is an ECG for analysis.
#EPeeps
#CardioTwitter
@ecgrhythms
@ECGfan
@ECG_Emily
@GhaithAlmidani
@laura_goodliffe
@dog_oculus
@bishoydf
@NimaZamiri
@adribaran
@CHRS_SCR
@rudyunni
@yaS0_0Ser
@UlhasDr
10
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This 19 yrs old male presented with palpitations. Thoughts?
#EPeeps
#cardiotwitter
. Will post the EP study results later.
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Young man with recurrent palpitation. We don’t need an EP study to know the diagnosis correct?
@EPeeps_Bot
@dog_oculus
@ELabartkava
@UlhasDr
@chaturvedimd
@bishoydf
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Young asymptomatic male. Anything to be done?
#EPeeps
#FOAMed
#Medtwitter
#CardioTwitter
@EPeeps_Bot
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Where would you expect a lesion here ?
#EPeeps
#CardioTwitter
@ecgrhythms
@ECGfan
@MattMelcherPA
@DrRajeshG1
@UlhasDr
@EPeeps_Bot
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Undetected ASD/PFO is not uncommon in patients receiving CRM devices. Consequences could be serious if leads are implanted unknowingly in left chambers . Importance of lateral views and LAO at implant.
#EPeeps
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"Reverse Wenckebach" is a pseudonym. This pattern is always abnormal and indicates severe infrahisian disease
#EPeeps
#EPfellows
@EPeeps_Bot
@BotCardiology
@NimaZamiri
@GhaithAlmidani
@dredcronin
@UlhasDr
@ELabartkava
@dog_oculus
@ECGfan
@ecgrhythms
@EcgImaging
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ECG Challenge :What is the likely diagnosis here?
60 yrs male, s/p CABG, LV 35%,This tachycardia responded to adenosine!
#EPeeps
#ECG
@EPeeps_Bot
@ecgrhythms
@ECGfan
@NimaZamiri
@GhaithAlmidani
@laura_goodliffe
@dog_oculus
@bishoydf
@adribaran
@UlhasDr
@MattMelcherPA
@ALFIEEP1
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An ECG for interpretation.
What is the likely mechanism of this tachycardia?
#Fellowsfirst
#CardioTwitter
#CardioEd
#FOAMed
@EPeeps_Bot
18
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An ECG for beginners. What is the diagnosis here?
#EPeeps
#Fellowsfirst
#Cardiotwitter
@EPeeps_Bot
@BotCardiology
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What is the diagnosis here? why? ECG challenge for cardiology trainees and ecg aficionados
#EPeeps
#CardioTwitter
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Trainees, there is a unique clinical finding described with this diagnosis. Can anyone answer that? This was a question we faced when we were medical students and residents
#ECG
@EPeeps_Bot
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An EGM for EP fellows. What is the diagnosis here?
#EPeeps
#EPfellows
@NimaZamiri
@dog_oculus
@HeartShiv
@MartowMartow
@EPeeps_Bot
@MattMelcherPA
@ALFIEEP1
@dredcronin
@Doc_AleCuesta
@UlhasDr
@anunay_cardio
@KakkamKrishna
@SignalstEPh
@MonaghanJenieca
@Ghassanj89
@GhaithAlmidani
11
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A reverse loop approach would give a stable position under the tricuspid valve for otherwise difficult to reach areas. A case of PVCs from midspetum close to His Bundle area successfully ablated by this approach. LAMP 90 sheath used for stability
#EPeeps
8
13
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An interesting ECG for trainees and ECG aficionados.
What is the most likely diagnosis here?
#EPeeps
#Cardiotwitter
@EPeeps_Bot
16
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An interesting case of bigeminal rhythm. Thoughts?
#EPeeps
#Fellowsfirst
@bishoydf
@dog_oculus
@EPeeps_Bot
@DidlakeDW
@brun_dav
@UlhasDr
@McMasterIntMed
@CHRS_SCR
@MaruanCarlos
@GhaithAlmidani
@ecgrhythms
@ECG_Emily
@MattMelcherPA
15
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ECG exercise of the day. EP/Cardiology fellows! What is the likely diagnosis here?
#EPeeps
#Fellowsfirst
#ECG
@NimaZamiri
@laura_goodliffe
@GhaithAlmidani
@yaS0_0Ser
@dog_oculus
@MartowMartow
@HeartShiv
@mahishasur
@UlhasDr
@ecgrhythms
@ecgrhythms
@adribaran
@SergioPinski
16
16
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An interesting QRS alternans. Thoughts?
#EPeeps
#Fellowsfirst
@EPeeps_Bot
@ecgrhythms
@ECGfan
@adribaran
@SergioPinski
@CHRS_SCR
@McMasterIntMed
@DidlakeDW
@MaruanCarlos
@UlhasDr
@KevinJohnUm
@MattMelcherPA
@bordistef
@dog_oculus
@Doc_AleCuesta
@KakkamKrishna
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Can we ever understand this arrhythmia at all? AVNRT with complete AV block. Young female with SVT,typical AVNRT, patient developed mechanical AV block with His catheter placement.Tachy continued!Rrecovered after>1 hour, successfully ablated after!
#EPeeps
@EPeeps_Bot
@ALFIEEP1
11
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An interesting ECG for analysis. What is the likely diagnosis?
#EPeeps
#CardioTwitter
@adribaran
@SergioPinski
@UlhasDr
@NimaZamiri
@GhaithAlmidani
@dog_oculus
@bishoydf
@laura_goodliffe
@EPeeps_Bot
@anunay_cardio
@Doc_AleCuesta
@MaruanCarlos
@ecgrhythms
@CHRS_SCR
12
26
63
An ECG for discussion. What is the likely diagnosis in this patient with palpitation?
#EPeeps
#Fellowsfirst
#Cardiotwitter
#FOAMed
11
12
62
STEMI with LBBB . Apart from the glaring ST changes of
#Sgarbossa
criteria, q waves in lateral leads, however small is indicative of MI. Culprit here?
#EPeeps
@EPeeps_Bot
@ecgrhythms
@laura_goodliffe
@GhaithAlmidani
@dog_oculus
@UlhasDr
@MaruanCarlos
@DidlakeDW
@MaruanCarlos
20
20
64
ECG for residents and medical students. Ventriculophasic sinus arrhythmia. PP intervals which contain a QRS is shorter than those without. Seen with high grade AV blocks and CHB. What are the purported mechanisms?
#EPeeps
#Cardiotwitter
@EPeeps_Bot
@CHRS_SCR
@BotCardiology
8
15
65
5
19
63
OHCA. Shockable rhythm. What would you expect in echo?
#EPeeps
#ECG
@EPeeps_Bot
@adribaran
@UlhasDr
@AsfDanon
@DidlakeDW
@DrRajeshG1
@ecgrhythms
@ECGfan
@EcgOxford
@bishoydf
@forkknifecab_EP
@GhaithAlmidani
@laura_goodliffe
@CHRS_SCR
@McMasterIntMed
20
21
61
ECG challenge for trainees. Describe the conduction here
#EPeeps
#cardiotwitter
@EPeeps_Bot
@BotCardiology
@GhaithAlmidani
@NimaZamiri
@dog_oculus
@laura_goodliffe
@HeartShiv
@MartowMartow
@rudyunni
@UlhasDr
@adribaran
@SergioPinski
@EcgImaging
@ecgrhythms
@SchakrabartiEP
15
17
63
7
16
64
Tracing challenge for fellows. Young pt with palpitations. Reproducible .What is the diagnosis?
#Epeeps
#Fellowsfirst
@NimaZamiri
@dog_oculus
@HeartShiv
@MartowMartow
@MaruanCarlos
@MattMelcherPA
@Doc_AleCuesta
@UlhasDr
@EPeeps_Bot
@Arritmias_HRC
@ALFIEEP1
@SignalstEPh
21
12
61
Cardiology/EP trainees, what is the complete ECG diagnosis here?
#EPeeps
#CardioTwitter
@adribaran
@GhaithAlmidani
@NimaZamiri
@laura_goodliffe
@MartowMartow
@rudyunni
@EPeeps_Bot
@ecgrhythms
@ECGfan
@ECG_Emily
@UlhasDr
@mahishasur
@yaS0_0Ser
@ELabartkava
@CHRS_SCR
15
15
60
Case from today's clinic. 39 yrs male, recurrent palpitations from the age of 10. termination with Valsalva. What is likely diagnosis
#Epeeps
? Antidromic AVRT or VT?
@ecgrhythms
@ECGfan
@ALFIEEP1
@javadm20
@UlhasDr
@CarinaHardy4
@EladAnter
@ELabartkava
@adribaran
15
20
62
Another ECG for trainees to analyze. Pateint with dual chamber ICD, programmed to AAIR-DDDR 60-120 . last visit AS/VS 99% .Worsening symptoms and ECG below.Anything abnormal?
#EPeeps
#Cardiotwitter
#Fellowsfirst
@GhaithAlmidani
@MartowMartow
@UlhasDr
@plantain_bender
@bishoydf
9
13
61
An interesting ECG Patient with ICD for primary prevention.
#EPeeps
#cardiotwitter
@EPeeps_Bot
@BotCardiology
@GhaithAlmidani
@NimaZamiri
@laura_goodliffe
@dog_oculus
@UlhasDr
@adribaran
@ecgrhythms
@ECGfan
@ECG_Emily
@EcgImaging
@ELabartkava
@SergioPinski
@MartowMartow
15
14
61
Post dual chamber pacemaker, Is everything OK? For cardology/EP trainees
#EPeeps
#Fellowsfirst
@EPeeps_Bot
@GhaithAlmidani
@dog_oculus
@MartowMartow
@HeartShiv
@KakkamKrishna
@UlhasDr
@mahishasur
@anunay_cardio
@NimaZamiri
@adribaran
@ecgrhythms
@ECG_Emily
13
13
61
Slow pathway potentials (described by one of the luminaries of EP Sonny Jackman)
#EPeeos
#EPfellows
#cardiotwitter
@EPeeps_Bot
@BotCardiology
11
14
60
54 yrs male, h/o recurrent palpitations since adolescence. Presented to ER with this. Likely diagnosis?
#EPeeps
#Fellowsfirst
@EPeeps_Bot
@NimaZamiri
@dog_oculus
@GhaithAlmidani
@DidlakeDW
@MattMelcherPA
@UlhasDr
@brun_dav
@CHRS_SCR
@McMasterIntMed
@UlhasDr
@MaruanCarlos
17
15
58
Middle aged man with chest pain! Paging the interventionists.. Where could be the problem?
#ECG
#CardioTwitter
15
14
57
An interesting ECG for discussion. How to describe this pattern? For Trainees and ECG aficionados. Beautifully reconstructed by PMCardio app from a terrible source!
#EPeeps
#FOAmed
#CardioTwitter
@EPeeps_Bot
@PMcardioBot
16
17
58
A tracing challenge to EP fellows and trainees. What is going on here?
#EPeeps
,
#EPFellows
@NimaZamiri
@dog_oculus
@MartowMartow
@GhaithAlmidani
@EPeeps_Bot
7
14
60
