How can accessory pathways cause excessively high heart beats, yet the absolute refractory period limits an immediate signal?

This has been something that's been bugging me and I can't seem to find an answer anywhere.

If the ARP limits how fast an electrical signal can be generated, how is it that an accessory pathway (i.e. WPW syndrome) can permit tachycardia rhythms (+250bpm?) If the main heart fibers are depolarized, how can a re-routed signal from an accessory pathway cause another signal? Should the depolarized cells prevent that from happening?

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πŸ‘€︎ u/questions4science
πŸ“…︎ Oct 09 2021
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WPW on a left lateral accessory pathway with anterograde conduction (16M)
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πŸ‘€︎ u/Asperguy07
πŸ“…︎ May 04 2021
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No p waves, under 100 bpm, irregular wide complex. svt with aberrancy/BBB? ventricular origin? accessory pathway? What are the clues?
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πŸ‘€︎ u/Estinyday
πŸ“…︎ Feb 20 2021
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Identify the origin of the accessory pathway, go!
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πŸ‘€︎ u/febreeze1
πŸ“…︎ Oct 22 2019
🚨︎ report
8 y/o with chest pain following radiofrequency ablation for an accessory pathway yesterday πŸ”ŠπŸ‘§πŸ½ Can you #SpotTheDiagnosis?
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πŸ‘€︎ u/EM3FOAMed
πŸ“…︎ Mar 06 2019
🚨︎ report
8 y/o with chest pain following radiofrequency ablation for an accessory pathway yesterday πŸ”ŠπŸ‘§πŸ½ Can you #SpotTheDiagnosis?
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πŸ‘€︎ u/EM3FOAMed
πŸ“…︎ Mar 06 2019
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Accessory pathways and atrial fibrillation

I read that up to 40% of patients with accessory pathways have atrial fibrillation. Does it mean that accessory pathways can cause atrial fibrillation (and if so, how?) or that the coexistence of these two conditions is incidental? Thanks in advance!

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πŸ‘€︎ u/sunset1098
πŸ“…︎ Nov 22 2019
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If a patient with a long history of EKG documented PSVT and a recent history of atrial fibrillation, is there a small possibility that both could be related to an occult accessory pathway in the absence of WPW on the EKG? How would you demonstrate this ?

My point is that if the accessory pathway could be ablated (as opposed to a AVNRT), it would be a rare situation in which lifelong anticoagulation would not be indicated irrespective of the CHAβ‚‚DSβ‚‚-VASc Score. thanks very much for your time and help

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πŸ‘€︎ u/Dorindon
πŸ“…︎ Jan 17 2019
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Book answer key says that this EKG is of Wolf Parkinson White syndrome. How do you differentiate this EKG from Vtach?
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πŸ“…︎ Jan 08 2022
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On the Natural History and Evolution of the Romans

Hi everyone. I was the guy that deduced and popularized what has recently become known as the β€œRoman master plan theory” on this subreddit, a theory that Ty and Daniel recently confirmed is correct. In the Alt-Shift X podcast where they confirmed it, they said that they felt they weren’t being subtle, and yet a ton of people seem to have completely missed this central part of the plot of Leviathan Falls. I think a major part of why I understood what the authors were going for is because I understood The Dreamer chapters in the book, and therefore understood the alien biology that they were trying to explain. A biology that is so alien that I think it actually challenges a lot of what we consider as β€œlife” in the first place.

So, I thought that I would make a thorough post on the evolution and history of the Gatebuilders, so that other fans can understand their nature and the overall alien plot line of the Expanse. My background is in biology and neurology, so I think I might be decently suited to make a post like this. I won’t go into detail about their β€œmaster plan” - there are multiple recent threads on that. Instead, this will delve into their biology and evolutionary history. I will refer to them as the Gatebuilders throughout this post because that is the name we seem to have collectively decided on as a fan base, but by the end of this post, you’ll see why I think that instead of calling them β€œGatebuilders”, we should instead call their species β€œLeviathans” - a name that I think suits them far better, both based on their origin and because they did far more than just build the gates, which probably wasn't even initially deliberate in the first place.

This will be long. VERY long. I apologize for the length, but there was a lot to discuss here. There’s a tl,dr below.

I will also say, for clarification, that I repeatedly refer to them as β€œGatebuilders”. But as Elvi points out, the plurality is a misnomer. The word β€œhive mind” is meaningless - all there is, is mind. Just as you and I are not a β€œhive mind” of the billions of neurons that contribute to our consciousness, so too were they not a β€œhive mind” of the myriad nodes that contributed to theirs. They were a mind, and therefore β€œGatebuilder” or β€œLeviathan”, singular, would be a more accurate term. But because that is almost grating to our human perception, I’ll continue to refer to them in the plural.

Most of this information is contained within The Dreamer chapters and Elvi’s followup, expl

... keep reading on reddit ➑

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πŸ‘€︎ u/kabbooooom
πŸ“…︎ Jan 24 2022
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So, I went back and played L4D2

Man, while playing this game, I’ve heard a lot of people complain about how some things in L4D was better. Last I played L4D2 was 2016, so I redownloaded it and played No Mercy and Dark Carnival.

I think the atmosphere of the L4D series is better. It’s darker, more gruesome and fits a horror narrative. L4D games also had a lot more acts and varied missions through ya the acts. But you know why we didn’t complain much about it while we played it? It had no features. The β€œM16” (assault rifle) is my favorite gun in that game, once you find it, there is nothing else you have to look for but ammo and healing. Ammo is infinite and covers every ammo type. The laser attachment is about the only thing that makes you not want to lose a gun. But playing the game, it felt bare and like there was nothing to explore.

I do wish B4B had more than 3 acts that had more than one mission, and I wish those missions weren’t mostly the same mission with different pathways. But the card system, the gun rarity system, attachments, different accessories, it really makes each game different. B4B should’ve been released with a bit more context and less bugs, but it’s still an infant game full of potential. I’m looking forward to what the new expansions have to offer.

If anyone has played the L4D games recently, please let me know how your experience compared to mine.

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πŸ‘€︎ u/Heavionix
πŸ“…︎ Jan 01 2022
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[Streetwear] Rise of the Machines: The life and times of automated checkouts and the fight against them

In 1994, British American fashion designer and entrepreneur James Jebbia launched his retail magnum opus, Supreme. Twenty-six years later, and we’ve arrived at the current state of trying to buy anything online.

I kid. Well, mostly. The combination fashion/sneaker public did not invent automated checkouts, but these people have perfected the craft. It’s no longer a basic Python script, this is an art. A learning curve in and of itself. At the best of times, online shopping is a quick and convenient alternative to ever going outside. At the worst of times, items disappear from your cart mid coffee sip, stores sell out in an f5, your IP gets banned for unknown reasons, Chrome freezes irreversibly, and you log on to Twitter just to see someone with five-thousand orders placed on the thing you only wanted one of.

Bottingβ€”the use of automated checkout scriptsβ€”is a pathway to many abilities some consider to be unnatural. I’ve probably made that reference already, but it still stands. Users of the Dark Arts can have sneakers and box logo hoodies set for delivery without getting out of bed. They can order in the tens, dozens, hundreds at the highest level. And, ideally for them, they can flip this investment around into cold, hard profit. At least, they used to. As you might have heard, a bill has been reintroduced by House and Senate Democrats that if passed would crack down on online botting. For Americans, this sounds pretty good. On the other hand, it doesn’t feel like this should have come down to legislation, right? Why haven’t the companies making these products, selling these products, not just enable stricter anti-bot practices? More on that later, but when it comes to the bot hustle, we have a lot to unpack.

The Before Times

What does a drop day look like in 2022? A lot different from how things used to be, and not just because of times wot are unprecedented. Before Nike SNKRS, before Adidas Confirmed, before the site bandwidth nightmare that is Supreme New York Dot Com at 11am, getting the fashion pieces one wanted was beautifully simple. Things operated on (old) concert ticket logic; if you want it, line up. How early do you line up? Well, how badly do you want it?

The art of queueing up has not totally died. For the purists, or those fed up with botting, the line is still the preferred method of doing things. But lining up for shoes or clothes is not the same as lining up

... keep reading on reddit ➑

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πŸ‘€︎ u/freemanboyd
πŸ“…︎ Jan 02 2022
🚨︎ report
4 Wrangler Raids (Ramee, Hutch, Rick, Marty). A novel.

Written by me, Pat. In pain, as I have to wake up for work in 3 hours.


#Ramee Raid

TLDR; Ramee raided for possessing Wrangler's PD-issued SCAR-H rifle. Properties raided: Upper Power Street Apartment, all cars and boats, Vulture Le Culture Gallery. Ramee was close to both Drug and Weapon Trafficking, but a few guns/meth off.

this was over the course of 6 hours

Wrangler signed onto duty and learned that the Vagos had been consorting with prostitutes at the Dean's World Pier. After arriving at the Pier, he saw Taco Prince pointing an AK47 at someone attempting to drive down the side pathway past the pier. Wrangler called for 78s and attempted to stop Taco, before the other members of CG around (Randy, Ramee, and Mr K) shot Wrangler with AK47s. At that point, Angel took over the scene, which eventually led to Ramee being shot down. On his possessions, Ramee had a SCAR-H rifle which came back to Wrangler.

After Wrangler was seen by medics, Ramee was remanded to his custody in the interrogation rooms. Wrangler informed Ramee that the rifle he was found with was from a SWAT deployment just a few days previous, and that Ramee would be getting raided for possessing PD equipment, as other equipment from downed SWAT officers was taken as well but not found on Ramee.

Ramee gave consent for Wrangler to search his apartment before his lawyer, Murphy Braun, could arrive. Wrangler dressed up in a "grinder outfit" and locked down the apartment. While this was happening, Ramee beat up Cadet Aziz and took his rifle, holding him hostage before shooting two other cops. Ramee was then shot down himself.

Wrangler raided Ramee's apartment alone, dressed up in his "grinder outfit", completely avoiding the ambush that CG was actively setting up. Wrangler found guns, drugs, and a large sum of dirty money in Ramee's apartment, which allowed him to push for a raid warrant on all of Ramee's cars. Further items of note included an Octopus games invitation, VIP Mask, and the first half of a Casino Access Code.

Murphy Braun and Robert Locksley, along with "paralegal" Hutch Hutcherson, arrived to represent Ramee. Braun, upon hearing what Ramee was being charged with, initially questioned why he even wanted a lawyer. At this point, Wrangler was informed that felons were not allowed to be paralegals. However, Wrangler allowed Hutch to be there still, wanting to rope Locksley into a bar complaint if Hutch later interfered or used his knowledge from being in t

... keep reading on reddit ➑

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πŸ‘€︎ u/Logic-And-Raisin
πŸ“…︎ Nov 03 2021
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SERIOUS: This subreddit needs to understand what a "dad joke" really means.

I don't want to step on anybody's toes here, but the amount of non-dad jokes here in this subreddit really annoys me. First of all, dad jokes CAN be NSFW, it clearly says so in the sub rules. Secondly, it doesn't automatically make it a dad joke if it's from a conversation between you and your child. Most importantly, the jokes that your CHILDREN tell YOU are not dad jokes. The point of a dad joke is that it's so cheesy only a dad who's trying to be funny would make such a joke. That's it. They are stupid plays on words, lame puns and so on. There has to be a clever pun or wordplay for it to be considered a dad joke.

Again, to all the fellow dads, I apologise if I'm sounding too harsh. But I just needed to get it off my chest.

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πŸ‘€︎ u/anywhereiroa
πŸ“…︎ Jan 15 2022
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A priest, a pastor, and a rabbit walk into a blood donation clinic.

The nurse asked the rabbit, β€œwhat is your blood type?”

β€œI am probably a type O” said the rabbit.

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πŸ‘€︎ u/snc8698
πŸ“…︎ Jan 29 2022
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I’ve got this disease where I can’t stop making airport puns.

The doctor says it terminal.

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πŸ‘€︎ u/xIR0NPULSE
πŸ“…︎ Jan 28 2022
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Just because it's a joke, doesn't mean it's a dad joke

Alot of great jokes get posted here! However just because you have a joke, doesn't mean it's a dad joke.

THIS IS NOT ABOUT NSFW, THIS IS ABOUT LONG JOKES, BLONDE JOKES, SEXUAL JOKES, KNOCK KNOCK JOKES, POLITICAL JOKES, ETC BEING POSTED IN A DAD JOKE SUB

Try telling these sexual jokes that get posted here, to your kid and see how your spouse likes it.. if that goes well, Try telling one of your friends kid about your sex life being like Coca cola, first it was normal, than light and now zero , and see if the parents are OK with you telling their kid the "dad joke"

I'm not even referencing the NSFW, I'm saying Dad jokes are corny, and sometimes painful, not sexual

So check out r/jokes for all types of jokes

r/unclejokes for dirty jokes

r/3amjokes for real weird and alot of OC

r/cleandadjokes If your really sick of seeing not dad jokes in r/dadjokes

Punchline !

Edit: this is not a post about NSFW , This is about jokes, knock knock jokes, blonde jokes, political jokes etc being posted in a dad joke sub

Edit 2: don't touch the thermostat

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πŸ‘€︎ u/CzarcasmRules
πŸ“…︎ Jan 23 2022
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The r/indieheads Album of the Year 2021 Write-Up Series: Parannoul - To See the Next Part of the Dream

Howdy! Welcome to Day 11 of the r/indieheads Album of the Year 2021 Write-Up Series, our annual event where we showcase pieces from some of our favorite writers on the subreddit talking about their favorite records of the year! Today, we have u/GalacTech discussing Parannoul's To See the Next Part of the Dream!

February 23rd, 2021 - self-released

Background by u/GalacTech:

Parannoul is the moniker of an anonymous South Korean musician from Seoul. On February 23rd, 2021, he released his Sophomore album, To See The Next Part of the Dream on BandCamp. As the days went on from the initial release, people began to take notice of the album through RateYourMusic’s β€œNew” chart, leading to an exponential increase in listeners, and an eventual debut as the top album of 2021.

Writeup by u/GalacTech:

Today is December 11th, 2021.

9 Months and 2 days ago, I sent an email at 2:30 in the morning that would change my life forever.

9 Months ago, on this same day, I embarked on a journey with my South Korean friend to sell some cassette tapes of his album.

That album was called To See the Next Part of the Dream.

You don't know who I am, however, if you follow the β€œemo” zeitgeist, RateYourMusic, or the marketing buzzword known as β€œfifth-wave emo”, you're more than likely acquainted with my friends, and to a lesser extent, my label, Longinus Recordings.

I’m sure if you had told me on March 8th that I’d decided to start a record label, I’d say that you're out of your damn mind. If you told me it’d be successful, I’d be even more confused.

It's surreal, looking at it now, to see just what that album has become. I’m sure both of us thought that it shouldn't've been possible. It’s not 2011. But against all odds, the album broke through.

Am I really surprised by how many people resonated with it? That I resonated with it? Truth be told, I’m not.

I remember watching Neon Genesis Evangelion, and Welcome to the NHK with my best friend in sophomore year of high school, and being profoundly influenced by those media. It was strange for me to see someone embrace media so wholeheartedly that was otherwise esoteric. It was even stranger to see them included as ancillary segments in a body of work that was intensely profound.

At least for all my life, you get called β€œweird” for talking about E

... keep reading on reddit ➑

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πŸ‘€︎ u/IndieheadsAOTY
πŸ“…︎ Dec 11 2021
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Blind Girl Here. Give Me Your Best Blind Jokes!

Do your worst!

πŸ‘︎ 5k
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πŸ‘€︎ u/Leckzsluthor
πŸ“…︎ Jan 02 2022
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I heard that by law you have to turn on your headlights when it’s raining in Sweden.

How the hell am I suppose to know when it’s raining in Sweden?

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πŸ‘€︎ u/justshtmypnts
πŸ“…︎ Jan 25 2022
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Puns make me numb

Mathematical puns makes me number

πŸ‘︎ 9k
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πŸ‘€︎ u/tadashi4
πŸ“…︎ Jan 26 2022
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So my mom is getting her foot cut off today.. (really)

We told her she can lean on us for support. Although, we are going to have to change her driver's license, her height is going down by a foot. I don't want to go too far out on a limb here but it better not be a hack job.

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πŸ‘€︎ u/Slimybirch
πŸ“…︎ Jan 27 2022
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Petition to ban rants from this sub

Ants don’t even have the concept fathers, let alone a good dad joke. Keep r/ants out of my r/dadjokes.

But no, seriously. I understand rule 7 is great to have intelligent discussion, but sometimes it feels like 1 in 10 posts here is someone getting upset about the jokes on this sub. Let the mods deal with it, they regulate the sub.

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πŸ‘€︎ u/drak0ni
πŸ“…︎ Jan 24 2022
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French fries weren’t cooked in France.

They were cooked in Greece.

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πŸ“…︎ Jan 20 2022
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When I was a single man, I had loads of free time.

Now that I listen to albums, I hardly ever leave the house.

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πŸ‘€︎ u/porichoygupto
πŸ“…︎ Jan 25 2022
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You've been hit by
πŸ‘︎ 6k
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πŸ‘€︎ u/mordrathe
πŸ“…︎ Jan 20 2022
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My 4 year oldest favourit joke, which he very proudly memorized and told all his teachers.

Two muffins are in an oven, one muffin looks at the other and says "is it just me, or is it hot in here?"

Then the other muffin says "AHH, TALKING MUFFIN!!!"

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πŸ‘€︎ u/smoffatt34920
πŸ“…︎ Jan 22 2022
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I'm sick of you guys posting dumb wordplay in here for awards and upvotes.

Don't you know a good pun is its own reword?

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πŸ‘€︎ u/diggitygiggitycee
πŸ“…︎ Jan 21 2022
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Dropped my best ever dad joke & no one was around to hear it

For context I'm a Refuse Driver (Garbage man) & today I was on food waste. After I'd tipped I was checking the wagon for any defects when I spotted a lone pea balanced on the lifts.

I said "hey look, an escaPEA"

No one near me but it didn't half make me laugh for a good hour or so!

Edit: I can't believe how much this has blown up. Thank you everyone I've had a blast reading through the replies πŸ˜‚

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πŸ‘€︎ u/Vegetable-Acadia
πŸ“…︎ Jan 11 2022
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What starts with a W and ends with a T

It really does, I swear!

πŸ‘︎ 6k
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πŸ‘€︎ u/PsychedeIic_Sheep
πŸ“…︎ Jan 13 2022
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.
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πŸ‘€︎ u/SupremePalash
πŸ“…︎ Jan 29 2022
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My wife left me because I couldn’t stop doing impressions of pasta

And now I’m cannelloni

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πŸ‘€︎ u/bluestratmatt
πŸ“…︎ Jan 23 2022
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Why did Karen press Ctrl+Shift+Delete?

Because she wanted to see the task manager.

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πŸ‘€︎ u/Eoussama
πŸ“…︎ Jan 17 2022
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Steve JOBS would have made a better President than Donald Trump

But that’s comparing apples to oranges

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πŸ‘€︎ u/Ok-Ingenuity4838
πŸ“…︎ Jan 22 2022
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I just flew in from Chernobyl

And boy are my arms legs.

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πŸ‘€︎ u/JhopkinsWA
πŸ“…︎ Jan 23 2022
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My 7 year old daughter just told me this one. I'm so proud. What did the duck say when he bought chapstick?

Put it on my bill

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πŸ‘€︎ u/BigRedHusker_X
πŸ“…︎ Jan 26 2022
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Girlfriend got me good. Never been more proud of her.

Said if she ever hosts a gender reveal party, when it comes time to pop the balloon she'll spray everyone with water.

Gender is fluid.

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πŸ‘€︎ u/Mannheimd
πŸ“…︎ Jan 29 2022
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So 2 trees got arrested in the town I live...

Heard they've been doing some shady business.

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πŸ‘€︎ u/K1ll47h3K1n9
πŸ“…︎ Jan 18 2022
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What do you call a woman who’s really good at darts?

Amy

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πŸ‘€︎ u/Cinema_King
πŸ“…︎ Jan 29 2022
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I was almost upset that my coffee tasted like dirt today

but then I remembered it was ground this morning.

Edit: Thank you guys for the awards, they're much nicer than the cardboard sleeve I've been using and reassures me that my jokes aren't stale

Edit 2: I have already been made aware that Men In Black 3 has told a version of this joke before. If the joke is not new to you, please enjoy any of the single origin puns in the comments

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πŸ‘€︎ u/scarf_spheal
πŸ“…︎ Jan 19 2022
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No gains
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πŸ‘€︎ u/ridi86
πŸ“…︎ Jan 22 2022
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How eggs-traordinary
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πŸ‘€︎ u/Rix27_
πŸ“…︎ Jan 21 2022
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Duckduckgo
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πŸ‘€︎ u/findmebatman
πŸ“…︎ Jan 28 2022
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What is the scariest tree?

BamBOO!

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πŸ‘€︎ u/K1ll47h3K1n9
πŸ“…︎ Jan 18 2022
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This subreddit is 10 years old now.

I'm surprised it hasn't decade.

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πŸ‘€︎ u/frexyincdude
πŸ“…︎ Jan 14 2022
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Why does Spider-Man's calendar only have 11 months?

He lost May

πŸ‘︎ 8k
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πŸ‘€︎ u/Toku-Nation
πŸ“…︎ Jan 26 2022
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