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Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chestpain. Annals of Emergency Medicine 2012; 60(12):766-776. LAFB, atrialflutter, anterolateral STEMI(+) OMI.
To me, it was clearly atrialflutter with 1:1 conduction. The rate of 280 is just right for atrialflutter. The waves look like atrialflutter waves, NOT like a wide ventricular complex. Recently diagnosed with intermittent paroxysmal atrial fibrillation but no EKGs available to confirm.
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