Dr. Smith's ECG Blog

JANUARY 9, 2024

The ECG was interpreted as showing atrial flutter with 2:1 conduction. Are you confident there is no ischemia? The heart rate could be compatible with that of a 2:1 conducted atrial flutter. Also, lead I could give the initial impression of showing flutter waves. Do you agree with this strategy?

Tachycardia 119

Tachycardia Electrophysiology Atrial Flutter Ischemia 119

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 14, 2023

My interpretation was: RBBB with hyperacute T-waves in V4-V6 that are all but diagnostic of LAD occlusion vs. post ROSC ischemia. For more on the application of this Trace-down; Copy-over technique with Shark Fin ST segment deviations — See My Comment in the May 19, 2020 post in Dr. Smith's ECG Blog.

Cardiac Arrest 98

Cardiac Arrest Chest Pain Defibrillator Atrial Flutter 98

Dr. Smith's ECG Blog

OCTOBER 25, 2022

We see a regular tachycardia with a narrow QRS complex and no evidence of OMI or subendocardial ischemia. 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.

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?) Lots of info here.

Chest Pain 52

Chest Pain Pulmonary Sickle Cell Disease Atrial Flutter 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 a large peaked P-wave in lead II (right atrial enlargement) There is left axis deviation consistent with left anterior fascicular block. There is no evidence of infarction or ischemia. There is atrial activity before every QRS, but that activity has negative polarity, so it is not sinus rhythm.

Heart Failure 52

Heart Failure Tachycardia Atrial Flutter Cardiomyopathy 52