Atrial Flutter Chest Pain Tachycardia 
Dr. Smith's ECG Blog
JANUARY 9, 2024
She had a single chamber ICD/Pacemaker implanted several years prior due to ventricular tachycardia. She presented to the emergency department after a couple of days of chest discomfort. The ECG was interpreted as showing atrial flutter with 2:1 conduction. Answer : The ECG above shows a regular wide complex tachycardia.
Dr. Smith's ECG Blog
SEPTEMBER 17, 2021
40-something yo who is on flecainide and diltiazem had sudden onset chest pain, palpitations, shortness of breath and diaphoresis : Rate is 220. So it is not atrial fib and not VT. It is a regular narrow complex tachycardia. If you look closely at lead II across the bottom, it appears there are flutter waves.
Dr. Smith's ECG Blog
DECEMBER 27, 2014
A male in his 60's called 911 for dizziness and chest pain, onset with exertion. Here is his initial rhythm strip (it is not a full 10 seconds): Wide complex tachycardia, rate 235 This is a very wide complex regular tachycardia at a rate of 235. It should be considered to be Ventricular Tachycardia and treated as such.
Dr. Smith's ECG Blog
AUGUST 3, 2018
In the evening, a middle-aged man complained of chest pain at the nursing home. His chest pain was vague. He mentioned "cancer" and "chest". He mentioned "cancer" and "chest". There is a narrow complex tachycardia at a rate of 130. Leads II and aVF appear to have flutter waves. Is is sinus?
Dr. Smith's ECG Blog
AUGUST 14, 2023
Written by Pendell Meyers, with some edits by Smith A man in his 40s with many comorbidities presented to the ED with chest pain, hypotension, dyspnea, and hypoxemia. The rhythm is 2:1 atrial flutter. An 80-something woman who presented with chest pain and dyspnea. Here is his triage ECG: What do you think?
Dr. Smith's ECG Blog
SEPTEMBER 18, 2024
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.
Dr. Smith's ECG Blog
JULY 16, 2024
This is the prehospital ECG from an 81 year old man with acute chest pain. There are 2 atrial "bumps" for every QRS. Here I put arrows: Arrows shows slow atrial flutter waves. My "Go To" Leads when I find myself searching for atrial activity are leads II, III, aVF — lead aVR — and lead V1. Look at V1.
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