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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. Because the patient was exercising, which increases sympathetic tone, facilitating AV conduction.
The WCT is interrupted by a series of variable-morphology QRS complexes, with atrialflutter waves note in II, III, and aVF. Detail of Flutter waves The rate of the flutter waves matches the rate of the WCT (about 200/m), proving that the presenting WCT had been 1:1 atrialflutter.
In healthy individuals occurs during exercising or strong emotions. AFIB/AFL – atrial fibrillation or atrialflutter episodes. ECG waveform Cardiomatics catalog of ECG events: Sinus rhythm – the normal heart rhythm is the sinus rhythm generated by the physiological pacemaker, the sinus node.
The principal differential diagnosis of a regular SVT rhythm includes 4 entities: i ) Sinus tachycardia; ii ) A reentry SVT ( either AVNRT if the reentry circuit is contained within the AV node — or AVRT if an accessory pathway located outside the AV node is involved ) ; iii ) Atrial Tachycardia; or , iv ) AtrialFlutter with 2:1 AV conduction.
REM Sleep: Each percent increase in nightly REM sleep duration was associated with a lower risk of atrial fibrillation, atrialflutter, and bradycardia (an abnormally slow heart rhythm). Deep sleep: Each percent increase in deep sleep was associated with a lower risk of atrial fibrillation, depression, and anxiety.
The Differential Diagnosis is: SVT with aberrancy(#) [AVNRT vs. WPW (also called AVRT*)] Atrialflutter 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.
Atrialflutter with 2:1 conduction. The atrialflutter rate is approximately 200 bpm, with 2:1 AV conduction resulting in ventricular rate almost exactly 100 bpm. Further history revealed she had new onset atrialflutter soon after her aortic surgery, and was put on flecainide approximately 1 month ago.
Previously healthy, taking no medication and exercising regularly. No anginal symptoms asymptomatic during physical exercise. An exercise stress test while taking the drug can be performed ensure that the QRS does not increase further at higher heart rates (ie, as a result of flecainide's use-dependence ).
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