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It is atrialflutter with 2:1 conduction. There are clear flutter waves in lead II across the bottom. In V1, there are upright waves that appear to be P-waves but are not: they are atrial waves and it is typical for atrialflutter waves to be upright in V1, whereas sinus P-waves are biphasic in V1.
Two recent interventions have proven in randomized trials to improve neurologic survival in cardiac arrest: 1) the combination of the ResQPod and the ResQPump (suction device for compression-decompression CPR -- Lancet 2011 ) and 2) Dual Sequential defibrillation. Finally, head-up CPR (which was not used here), makes for better resuscitation.
By this definition, a variety of rhythms may qualify as “SVTs” — including sinus tachycardia, atrialflutter or fibrillation, MAT, AVRT/AVNRT, among others. ECG Blog #138 — AFlutter vs Atrial Tachycardia. ECG Blog #40 — Another regular SVT that turned out to be AFlutter.
PEARL # 3: At this point — the most time-efficient step for solving today's rhythm will be to determine the nature of atrial activity. This type of Wenckebach response that may be seen with atrial tachycardia ( or atrialflutter ) — is often physiologic, as a result of the rapid atrial rate that occurs with these arrhythmias.
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