Reading the Warning Signs in High-Risk ECG Patterns

In the Djakarta B+C Room, the workshop “ECG Interpretation for Acute Care: Identifying High-Risk and Red-Flag Patterns” was held as part of the 13th Annual Scientific Meeting InaHRS 2026, themed “Rhythm of Life: Latest Innovations in Arrhythmology.” Guided by Course Director Sebastian Andy Manurung, MD, the session focused on systematic ECG interpretation to identify ischemia, dangerous arrhythmias, conduction abnormalities, and other high-risk conditions requiring timely intervention.

Ragil Nur Rosyadi, MD, opened with “When Myocardium Cries for Help,” introducing the fundamental ECG waves and intervals before discussing patterns of myocardial ischemia and infarction. Arsha Pramudya, MD, followed with “Wide QRS Tachycardia: A Systematic Approach to Avoid Fatal Misdiagnosis,” emphasizing the importance of clinical context and recognizing that hemodynamic stability does not exclude potentially life-threatening arrhythmias.

After the coffee break, Ragil Nur Rosyadi, MD, presented “Red Flags in Bradycardia and Conduction Disorders,” covering physiological and pathological causes of bradycardia, including sinus node dysfunction, ischemia, hypothyroidism, electrolyte disturbances, and medication effects, as well as chronotropic incompetence. Arsha Pramudya, MD, then discussed “Channelopathies, Electrolyte Emergencies, and Drug Toxicity,” highlighting ECG features of inherited arrhythmia syndromes such as Brugada syndrome, Long QT syndrome, CPVT, and Short QT syndrome.

The final session, “ECG-Guided Pharmacologic Management of Acute Arrhythmias,” was led by Sebastian Andy Manurung, MD, emphasizing an approach based first on hemodynamic stability and then on QRS width, with wide QRS tachycardia treated as ventricular tachycardia until proven otherwise.

Overall, the workshop emphasized ECG interpretation as more than rhythm recognition, but as a process of spotting warning signs, weighing clinical risk, and translating findings into timely action.