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Reposted by Willy Frick

brookswalsh @brookswalsh.bsky.social · 22/01/2026

Even with AI technology, clinical judgement remains essential. This ECG shows a lot of ST elevation, and the sophisticated AI ECG interpretation also points towards acute occlusion, but just barely. Activate the lab? @willyhfrick.bsky.social drsmithsecgblog.com/stemi-positi...

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Willy Frick @willyhfrick.bsky.social · 21/10/2025

Do #EPeeps believe in AVNRT upper common pathway (block)? This patient had: 1. AH jump 2. Septal VA < 80 ms 3. Concentric A during SVT 4. During RVP: (Stim-A)-(V-A) > 85 ms 5. During RVP: PPI-TCL > 115 ms 6. SVT terminated by RV burst pacing 7. Ablation in TOK rendered non-inducible

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Willy Frick @willyhfrick.bsky.social · 18/10/2025

Ablation in this location was successful.

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Willy Frick @willyhfrick.bsky.social · 20/06/2025

Now I'm really ready to start fellowship. ⚡⚡⚡ #EPeeps

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Willy Frick @willyhfrick.bsky.social · 17/06/2025

hqmeded-ecg.blogspot.com/2025/06/ante... Does the culprit match? #ECGSky #Medsky #cardiosky

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Willy Frick @willyhfrick.bsky.social · 13/06/2025

Strictly speaking we try to avoid pacing asymptomatic patients

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Willy Frick @willyhfrick.bsky.social · 12/06/2025

Yeah I was surprised. This ECG is years ago and he actually still does not have a pacemaker!!

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Willy Frick @willyhfrick.bsky.social · 11/06/2025

But then how will I know to give six units of FFP for rebalanced coagulopathy of cirrhosis 😉

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Willy Frick @willyhfrick.bsky.social · 03/06/2025

Read our editorial at the link below! www.termedia.pl/Occlusion-my... #ECGSky #Medsky #cardiosky @ecgcases.bsky.social

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Willy Frick @willyhfrick.bsky.social · 28/05/2025

My EP attending says EPs invoke superconduction and concealed conduction when they don't know what is happening 😂 I'm open to different interpretations for the changing QRS axis. I shared the ECG with a few folks and not everyone was convinced by that. What do you think explains the axis shift?

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Willy Frick @willyhfrick.bsky.social · 28/05/2025

Jerry, thanks for all your detailed thoughts! Agree re: lead I, most of what I said was geared at skepticism from one person I shared the ECG with so I thought others might have similar skepticism.

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Willy Frick @willyhfrick.bsky.social · 14/05/2025

I also saw the rhythm start and stop with PVCs.

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Willy Frick @willyhfrick.bsky.social · 14/05/2025

And this? Premature but with unchanged morphology. Concealed fusion with nearby PVC? Wobble feels unsatisfactory since cycle length is otherwise stable. @narrowqrs.bsky.social @danacjohnson.medsky.social @shah.md @jeffreyvinocur.bsky.social @alexturinmd.bsky.social @daverichley.bsky.social Help.

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Willy Frick @willyhfrick.bsky.social · 14/05/2025

60M with severe ischemic cardiomyopathy, prior inferoposterior OMI. Overall impression is VT with fusion complexes. But...fusion with what? I thought supraventricular capture at first, but I am leaning more toward fusion with unrelated PVCs now.

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Willy Frick @willyhfrick.bsky.social · 25/04/2025

I can't figure out an elegant explanation for the intermittent aberrancy. Anyone? #ECGsky #Medsky #cardiosky #EPeeps

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Willy Frick @willyhfrick.bsky.social · 14/04/2025

I’ve noticed this on Instagram as well.

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Willy Frick @willyhfrick.bsky.social · 13/04/2025

Discussed with some rhythm friends, not everyone is convinced by superconduction. Thoughts? Including a prior sinus-ish tracing for comparison. @danacjohnson.medsky.social @narrowqrs.bsky.social @shah.md @jeffreyvinocur.bsky.social @alexturinmd.bsky.social @daverichley.bsky.social

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Willy Frick @willyhfrick.bsky.social · 13/04/2025

My interpretation: Reverse typical flutter with dual level AVB as shown. Native complexes conduct with LAFB. R2 is Ashman beat. R4, R6 with superconduction through LAF. R8 unclear? Possible superconduction through a subdivision of LAF?

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Willy Frick @willyhfrick.bsky.social · 12/04/2025

So much to see here!! What explains the various QRS morphologies? #ECGsky #cardiosky #EPeeps #medsky

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Willy Frick @willyhfrick.bsky.social · 12/04/2025

I always thought it's hard to give people interested in EP a "taste" of what it's really like to know if they'd be interested. So far, your videos are by far the best resource I know of for interested trainees.

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Reposted by Willy Frick

J.M. Cooper @narrowqrs.bsky.social · 10/04/2025

VT entrainment. Some of you want to learn it from the beginning. Some just want the punchline. Here's a direct link to the climax of the video, with examples of all the possible entrainment locations (isthmus, entrance, exit, bystander, outer loop, etc) youtu.be/XykkZNLm9bc?...

youtu.be

VT Entrainment Mapping of Scar/Reentry VT

YouTube video by Dr. Joshua Cooper - Arrhythmia Education

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Willy Frick @willyhfrick.bsky.social · 08/04/2025

Answer: This is sinus tachycardia with complete heart block. Attach transcutaneous pacer pads and begin pacing at high output. Continuing CPR will do nothing for this, and he will always be pulseless at pulse check. This is why PEA can be a dangerous “diagnosis.”

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Willy Frick @willyhfrick.bsky.social · 07/04/2025

No pulse. Don’t have an increased gain available.

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Willy Frick @willyhfrick.bsky.social · 07/04/2025

Overhead page code blue. You arrive bedside to find ongoing chest compressions. First pulse check, you see this. What next? #cardiosky

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Willy Frick @willyhfrick.bsky.social · 06/04/2025

Glad to see the Australian guidelines reflect the data where American guidelines (@accintouch.bsky.social) were stuck in an antiquated era. The best time to move on from STEMI was years ago. The second best time is now. www.heartfoundation.org.au/for-professi... #medsky #cardiosky #ECGsky

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Willy Frick @willyhfrick.bsky.social · 04/04/2025

Fred W. Frick, MD FACP, inducted 2000 William H. Frick, MD FACP, inducted 2025 @acpimphysicians.bsky.social

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Willy Frick @willyhfrick.bsky.social · 02/04/2025

As you likely know, typically the way to dedifferentiate dextrocardia vs LA/RA reversal is with the precordial leads. I think this is a hard one due to the repolarization abnormality, but I think it can be discerned from ECG.

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Willy Frick @willyhfrick.bsky.social · 01/04/2025

Great write up. Tough case. I’m sure this would’ve gone the same way 9 times out of 10.

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Willy Frick @willyhfrick.bsky.social · 01/04/2025

Tough ECG. This is dextrocardia with quadrigeminal PVC fusion. Patient also has hypertrophy of the systemic ventricle (anatomically, the RV since dextrocardia) which is why it doesn’t look like “usual” dextrocardia. There is hypertrophy repolarization abnormality.

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Willy Frick @willyhfrick.bsky.social · 31/03/2025

Sometimes you gotta write out your feelings 😬

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Reposted by Willy Frick

Zaven Sargsyan @sargsyanz.bsky.social · 30/03/2025

"Your symptoms are critically important to me… If you have ANY chest discomfort [or whatever symptom the patient was experiencing] I need to know immediately. Please tell me or tell your nurse, because that would be an emergency." hqmeded-ecg.blogspot.com/2025/03/ever... @willyhfrick.bsky.social

hqmeded-ecg.blogspot.com

Everyone sees ST depression, but what does it mean?

Emergency cardiac care, cardiology, EKGs, ECGs, electrocardiography, echocardiography, dysrhythmias, arrhythmias, STEMI, NonSTEMI, NSTEMI, cardiology

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Reposted by Willy Frick

J.M. Cooper @narrowqrs.bsky.social · 16/03/2025

🚨 OMG, I actually just sat down and did my video narration of my VT entrainment talk (!!!) I'm converting to MP4 video right now. Might upload to YouTube soon, or I might go to bed and upload within the next day. But holy cow, it was a big effort and I'm so glad to get it done!!!!

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Willy Frick @willyhfrick.bsky.social · 15/03/2025

New update just dropped in the coronary anomalies section!

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Willy Frick @willyhfrick.bsky.social · 09/03/2025

A lot of baseline artifact but agree V1-3 very suspicious for posterior.

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Willy Frick @willyhfrick.bsky.social · 09/03/2025

I see what you mean. Yeah, the complete hemodynamic collapse seemed out of proportion with the findings (to me) which is part of why I felt like there could be a component of stress CMY.

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Willy Frick @willyhfrick.bsky.social · 08/03/2025

But hard to argue RV failure when wedge is high and RA is not. This is pre Impella.

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Willy Frick @willyhfrick.bsky.social · 08/03/2025

Agree RP could've been considered. She was hemodynamically stable until she wasn't and family asked for cessation of resuscitation efforts. RHC tracings attached.

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