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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

The ECG was interpreted as showing atrial flutter with 2:1 conduction. 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. The ECG shows what is likely an atrial ectopic rhythm with a left anterior hemiblock.

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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Look for Vascular Etiology -- think of these while doing H and P: --Bleeding: ruptured AAA, GI bleed, ruptured ectopic pregnancy, other spontaneous bleed such as mesenteric aneurysms. Annotated Bibliography For an excellent overview of ED Syncope management , see this article by Kessler C et al. starts at end of article on p.