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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. Reverted to atrial fibrillation with RVR while in the hospital 3 times and needed cardioversion.
male with pertinent past medical history including Atrial fibrillation, atrialflutter, cardiomyopathy, Pulmonary Embolism, and hypertension presented to the Emergency Department via ambulance for respiratory distress and tachycardia. Now you CAN on occasion see PVCs during reentry SVTs that do not convert the SVT.
Instead, the rate of 150, plus the history of AF, suggested atrialflutter. A close inspection of lead II showed P or flutter waves at a rate of about 300 bpm, also supporting atrialflutter. There appear to be flutter waves at a rate of 300. Flecainide encourages new atrialflutter.
The ECG was interpreted as showing atrialflutter with 2:1 conduction. The heart rate could be compatible with that of a 2:1 conducted atrialflutter. Also, lead I could give the initial impression of showing flutter waves. On her 5th hospital day — she was given Amiodarone, which successfully converted the rhythm.
Electrical cardioversion may be recommended for you if you have certain types of arrhythmias, such as: Atrial fibrillation (AFib): This is the most common type of arrhythmia, and it can cause symptoms like dizziness, fatigue, and difficulty breathing. Atrialflutter: This is a rapid but regular heart rhythm often progressing to AFib.
The patient was given furosemide and admitted to the hospital. There is atrial activity before every QRS, but that activity has negative polarity, so it is not sinus rhythm. The other atrialflutter types are: 1. A bedside POC cardiac ultrasound was done: Findings: Decreased left ventricular systolic function.
Patient history: It turns out that todays patient is an 80-something year old man with longstanding hypertension and paroxysmal atrial fibrillation. The AFib had been well controlled on Flecainide for many years. On this dose the atrial rate varied between ~180-200/minute during the 24 hours after admission.
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