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Syncope while on a treadmill

Dr. Smith's ECG Blog

To me, it was clearly atrial flutter with 1:1 conduction. The rate of 280 is just right for atrial flutter. The waves look like atrial flutter waves, NOT like a wide ventricular complex. Reverted to atrial fibrillation with RVR while in the hospital 3 times and needed cardioversion.

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ECG Blog #368 — Why So Fast?

Ken Grauer, MD

PEARL # 3: Atrial Flutter with 1:1 AV conduction is rare! Since the rate of atrial activity with flutter in adults is most often very close to 300 /minute ( ie, usual range for atrial activity ~250-350/minute ) — AFlutter with 2:1 AV conduction typically results in a regular ventricular rate of ~140-160/minute.

Blog 78
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A man in his 70s with acute chest pain and paced rhythm.

Dr. Smith's ECG Blog

Annals of Emergency Medicine 2012; 60(12):766-776. LAFB, atrial flutter, anterolateral STEMI(+) OMI. Diagnosis of Acute Myocardial Infarction in the Presence of Left Bundle Branch Block using the ST Elevation to S-Wave Ratio in a Modified Sgarbossa Rule. South African flag pattern, plus precordial swirl pattern.