Remove 2022 Remove Atrial Flutter Remove Tachycardia
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A young man with tachycardia. Should We Try Adenosine?

Dr. Smith's ECG Blog

There is a regular narrow complex tachycardia. Thus, it is supraventricular tachycardia. It is important to remember that SVT includes Sinus Tachycardia! Sometimes even Wide Complex Tachycardia is Sinus. See this case in which Lewis leads were necessary to figure this out: Wide Complex Tachycardia.

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A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

Dr. Smith's ECG Blog

She had a single chamber ICD/Pacemaker implanted several years prior due to ventricular tachycardia. The ECG was interpreted as showing atrial flutter with 2:1 conduction. Answer : The ECG above shows a regular wide complex tachycardia. The heart rate could be compatible with that of a 2:1 conducted atrial flutter.

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Syncope while on a treadmill

Dr. Smith's ECG Blog

This strip was obtained: Apparent Wide Complex Tachycardia at a rate of 280 What do you think? 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.

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Medics were criticized for not activating the cath lab

Dr. Smith's ECG Blog

There are 2 atrial "bumps" for every QRS. Here I put arrows: Arrows shows slow atrial flutter waves. I favor the P s, Q s, 3 R Approach — as a simple acronym to facilitate recall of the 5 KEY Parameters for rhythm interpretation ( See My Comment in the October 25, 2022 post in Dr. Smith’s ECG Blog ). Look at V1.

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Medical cardioversion of atrial fibrillation and flutter with class IC antiarrhythmic drugs in young patients with and without congenital heart disease

Journal of Cardiovascular Electrophysiology

Abstract Introduction The use of flecainide and propafenone for medical cardioversion of atrial fibrillation (AF) and atrial flutter/intra-atrial reentrant tachycardia (IART) is well-described in adults without congenital heart disease (CHD). The unit of analysis was each episode of AF/IART.

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Back to basics: what is this rhythm? What are your options for treating this patient?

Dr. Smith's ECG Blog

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.

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Electrical instability in a healthy 50 year old. How to manage?

Dr. Smith's ECG Blog

During observation in the ED the patient had multiple self-terminating runs of Non-Sustained monomorphic Ventricular Tachycardia (NSVT). This patient very likely has some form of idiopathic ventricular tachycardia. Of the ventricular outflow tract tachycardias (RVOT-VT) makes up 80-90%.