Ken Grauer, MD

DECEMBER 23, 2023

The August 17, 2020 post by me in Dr. Smith's ECG Blog — in which I review the phenomenon of Bradycardia-dependent BBB ( sometimes called "Phase 4" or "paradoxical" block ). ECG Blog #220 — reviews my L IST # 1 : Causes of a regular WCT ( and how to assess hemodynamic stability ). ECG Blog #242 — Reviews rate -related BBB.

Blog 176

Blog Tachycardia Tricuspid Atrial Flutter 176

Ken Grauer, MD

MARCH 12, 2023

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

Blog Atrial Flutter Arrhythmia AFIB 78

Dr. Smith's ECG Blog

NOVEMBER 15, 2020

So this is an extremely slow atrial flutter with 2:1 conduction. Atrial rate 146, ventricular rate 73. I suspect that the amyloid slows the conduction of the atrial flutter. It turned out that he had a history of slow atrial flutter. It turns out that this patient has cardiac amyloidosis.

Atrial Flutter 52

Atrial Flutter Cardiomyopathy Chest Pain Arrhythmia 52

Dr. Smith's ECG Blog

JULY 17, 2023

The principal differential diagnosis of a regular SVT rhythm includes 4 entities: i ) Sinus tachycardia; ii ) A reentry SVT ( either AVNRT if the reentry circuit is contained within the AV node — or AVRT if an accessory pathway located outside the AV node is involved ) ; iii ) Atrial Tachycardia; or , iv ) Atrial Flutter with 2:1 AV conduction.

Tachycardia 98

Tachycardia Atrial Flutter Blog Exercise 98

Dr. Smith's ECG Blog

OCTOBER 25, 2022

The differential of a regular narrow QRS tachycardia is sinus tachycardia, SVT, and atrial flutter with regular conduction. There are no P waves preceding the QRS complexes, and no clear flutter waves. We see a regular tachycardia with a narrow QRS complex and no evidence of OMI or subendocardial ischemia.

Tachycardia 52

Tachycardia Atrial Flutter Dysrhythmia Ablation 52

Dr. Smith's ECG Blog

AUGUST 14, 2023

The rhythm is 2:1 atrial flutter. The flutter waves can conceal or mimic ischemic repolarization findings, but here I don't see any obvious findings of OMI or subendocardial ischemia. The bedside echo showed a large RV (Does this mean there is a pulmonary embolism as the etiology?) Here is his triage ECG: What do you think?

Chest Pain 52

Chest Pain Pulmonary Sickle Cell Disease Atrial Flutter 52

Dr. Smith's ECG Blog

JANUARY 5, 2020

of all cases, and 62% of Veritas® misdiagnoses). == MY Comment , by K EN G RAUER, MD ( 1/5/2020 ): == This case illustrates a number of important teaching points. M Y A NSWER: In my experience, MAT is the 2nd-most commonly overlooked cardiac arrhythmia ( surpassed only by Atrial Flutter ).

Atrial Fibrillation 52

Atrial Fibrillation Tachycardia Arrhythmia Pulmonary 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

Dr. Smith's ECG Blog

MARCH 6, 2020

There is atrial activity before every QRS, but that activity has negative polarity, so it is not sinus rhythm. There are clearly no flutter waves, so it is not atrial flutter (a "macro-reentrant" atrial tachycardia) Is it AVNRT originating at the superior pole of the AV node, resulting in a retrograde P-wave before the QRS?

Heart Failure 52

Heart Failure Tachycardia Atrial Flutter Cardiomyopathy 52

Stroke Journal

OCTOBER 1, 2024

The aim of this study was to examine sex differences in prescription and adherence to GDMT at 1-year after ischemic stroke in a cohort of commercially insured patients.Methods:Using the Truven Health MarketScan database from 2016-2020, we identified patients admitted with ischemic stroke. The mean age was 55.7 vs 45.0%, P=0.003).

Stroke 40

Stroke Strokes Atrial Flutter 40

Journal of Cardiovascular Electrophysiology

MARCH 24, 2025

Methods and Results Between January 2020 and December 2023, 118 PeAF patients were selected for first intent Marshall plan ablation (MPA). After the blanking period of 3 months, 62/109 patients were in sinus rhythm (SR) (57%), 33/109 were in AF (30.2%), 8/109 were in left atrial flutter (AFL) (7.3%), and six were in right AFL (5.5%).

Atrial Fibrillation 40

Atrial Fibrillation Atrial Flutter Ablation Arrhythmia 40

Dr. Smith's ECG Blog

JANUARY 26, 2025

Note: The ECG in Figure-1 was initially recorded using the Cabrera Format ( See Comment by Dr. Grauer at the bottom of the page in the October 26, 2020 post for review of the Cabrera Format ). Before each of these WCT episodes the atrial rate decreased. Other than sinus rhythm What else do you see in this tracing?

Atrial Flutter 66

Atrial Flutter Tachycardia AFIB Hospital 66

Dr. Smith's ECG Blog

MARCH 6, 2025

Possible but, again, the QRS morphology is atypical 3) Atrial Flutter with 2:1 conduction and "aberrancy". I do not see flutter wave baseline, and again the QRS morphology is not typical for a supraventricular rhythm. See this case, for example: A Relatively Narrow Complex Tachycardia at a Rate of 180.

Tachycardia 96

Tachycardia Dysrhythmia ICU Pulmonary 96