Dr. Smith's ECG Blog

DECEMBER 24, 2023

Atrial flutter with 2:1 conduction. The atrial flutter rate is approximately 200 bpm, with 2:1 AV conduction resulting in ventricular rate almost exactly 100 bpm. Further history revealed she had new onset atrial flutter soon after her aortic surgery, and was put on flecainide approximately 1 month ago.

Atrial Flutter 127

Atrial Flutter Blog Aortic Aortic valve 127

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

The rhythm differential for narrow, regular, and tachycardic is sinus rhythm, SVT (encompassing AVNRT, AVRT, atrial tach, etc), and atrial flutter (another supraventricular rhythm which is usually considered separately from SVTs). Therefore this patient is either in some form of SVT or atrial flutter.

Ischemia 52

Ischemia Atrial Flutter Arrhythmia Tachycardia 52

Dr. Smith's ECG Blog

MAY 1, 2023

This narrows our differential for the rhythm down to sinus tachycardia, paroxysmal supraventricular tachycardia (PSVT, or SVT), and atrial flutter. The patient’s history is notable for paroxysmal atrial fibrillation, which raises clinical suspicion for atrial flutter, since these two entities frequently coexist on a spectrum.

Atrial Flutter 52

Atrial Flutter Tachycardia Arrhythmia Blog 52

Dr. Smith's ECG Blog

JULY 16, 2024

Here I put arrows: Arrows shows slow atrial flutter waves. The PEARL is that recognition of a longer-than-expected P wave in a supraventricular tachycardia should bring to mind the “Bix Rule” ( See My Comment at the bottom of the page in the August 3, 2018 post in Dr. Smith's ECG Blog ). These mimic ST Elevation. Arrhythmia?

Atrial Flutter 59

Atrial Flutter Chest Pain Tachycardia Arrhythmia 59

Dr. Smith's ECG Blog

AUGUST 3, 2018

Re-entrant tachycardias (atrial flutter, PSVT, AVRT, VT) have constant regular heart rates, whereas sinus tachycardia will usually gradually change rate with differing conditions (for instance, after infusion of fluid and BP increase, sinus tach rate might decrease from 130 to 125, for instance). So there is a re-entrant rhythm.

Chest Pain 40

Chest Pain Tachycardia Atrial Flutter Ultrasound 40

Dr. Smith's ECG Blog

MAY 8, 2023

LAFB, atrial flutter, anterolateral STEMI(+) OMI. EKG shown here: LAFB with no clear signs of OMI or ischemia. At 20 minutes from initial ECG, the patient's native rhythm spontaneously usurped the rhythm from the pacemaker: No knowledge or guidelines needed to see the OMI findings now! No labs were performed.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Pacemaker 52

Dr. Smith's ECG Blog

SEPTEMBER 7, 2020

The Differential Diagnosis is: SVT with aberrancy(#) [AVNRT vs. WPW (also called AVRT*)] Atrial flutter with 1:1 conduction, with aberrancy VT coming from the anterior fascicle ( fascicular VT )@ *AVRT = AV Reciprocating Tachycardia (Tachycardic loop that uses both the AV node and an accessory pathway.

Tachycardia 52

Tachycardia Heart Disease Dysrhythmia Ablation 52