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Willy Frick

@willyhfrick.bsky.social

400 followers 86 following 330 posts

Heart rhythm fellow. Medical educator. ECG enthusiast. Associate Editor of Dr. Smith's ECG Blog: https://drsmithsecgblog.com

drsmithsecgblog.com

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Willy Frick @willyhfrick.bsky.social · Nov 25

For anyone interested in learning more about angiography, check out my introductory guide!

You’ll find a lot of nice annotated diagrams like this one.

intuitivecardiology.notion.site/angiography

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Willy Frick @willyhfrick.bsky.social · Jun 20

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

#EPeeps

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Willy Frick @willyhfrick.bsky.social · Jun 17

hqmeded-ecg.blogspot.com/2025/06/ante...

Does the culprit match?

#ECGSky #Medsky #cardiosky

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Willy Frick @willyhfrick.bsky.social · Jun 13

Strictly speaking we try to avoid pacing asymptomatic patients

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Willy Frick @willyhfrick.bsky.social · Jun 12

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 · Jun 11

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

Willy Frick @willyhfrick.bsky.social · Jun 11

Does the constancy of the PVC coupling interval suggest triggered mechanism?

#ECGSky #MedSky #CardioSky

@jeffreyvinocur.bsky.social @narrowqrs.bsky.social @shah.md @danacjohnson.medsky.social @daverichley.bsky.social @alexturinmd.bsky.social

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Willy Frick @willyhfrick.bsky.social · Jun 10

I’m very proud of Dr. Lin for his first post on the blog.

#ECGSky #MedSky #CardioSky

Interns are not (yet) poisoned by the STEMI/NSTEMI paradigm

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

hqmeded-ecg.blogspot.com

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Willy Frick @willyhfrick.bsky.social · Jun 3

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 · May 28

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 · May 28

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.

Willy Frick @willyhfrick.bsky.social · May 26

#ECGSky #MedSky #CardioSky

What happens when a clinic does not have troponin testing for chest pain patients? Stress testing?

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

hqmeded-ecg.blogspot.com

Willy Frick @willyhfrick.bsky.social · May 25

I thought I had read this somewhere but I checked to make sure I wasn't just making stuff up. It was not actually from the Kosowski paper (which I thought is where I read it), it's from this one.

heart.bmj.com/content/42/4...

Multilevel block in the atrioventricular node during atrial tachycardia and flutter alternating with Wenckebach phenomenon.

The electrocardiograms of 100 patients with rapid and regular PP intervals during atrial arrhythmias (because of atrial tachycardia or flutter, or pacing) were examined for periods of irregular atriov...

heart.bmj.com

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Willy Frick @willyhfrick.bsky.social · May 24

How many findings can you name?

#ECGSky #EPeeps #cardiosky #medsky

And now for something completely different (a very difficult electrophysiology case)

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

hqmeded-ecg.blogspot.com

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Willy Frick @willyhfrick.bsky.social · May 14

I also saw the rhythm start and stop with PVCs.

Willy Frick @willyhfrick.bsky.social · May 14

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 · May 14

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 · Apr 25

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 · Apr 14

I’ve noticed this on Instagram as well.

Willy Frick @willyhfrick.bsky.social · Apr 13

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 · Apr 13

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 · Apr 12

So much to see here!! What explains the various QRS morphologies?

#ECGsky #cardiosky #EPeeps #medsky

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Willy Frick @willyhfrick.bsky.social · Apr 12

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.

Reposted by Willy Frick

J.M. Cooper @narrowqrs.bsky.social · Apr 10

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?...

VT Entrainment Mapping of Scar/Reentry VT

YouTube video by Dr. Joshua Cooper - Arrhythmia Education

youtu.be

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Willy Frick @willyhfrick.bsky.social · Apr 8

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.”

Willy Frick @willyhfrick.bsky.social · Apr 7

🤦‍♂️