Dr. Smith's ECG Blog
DECEMBER 24, 2023
Atrial flutter with 2:1 conduction. The atrial flutter 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 atrial flutter soon after her aortic surgery, and was put on flecainide approximately 1 month ago.
Dr. Smith's ECG Blog
NOVEMBER 26, 2018
The rhythm differential for narrow, regular, and tachycardic is sinus rhythm, SVT (encompassing AVNRT, AVRT, atrial tach, etc), and atrial flutter (another supraventricular rhythm which is usually considered separately from SVTs). Therefore this patient is either in some form of SVT or atrial flutter.
Dr. Smith's ECG Blog
DECEMBER 26, 2020
There is the appearance of STE in inferior leads II, III, and aVF (with STD in aVR), but this is entirely due to flutter waves which are only seen in those leads. Also, the atrial flutter in this case is relatively slow like in many other cases we've shown. Atrial Flutter with Inferior STEMI? Is this inferor STEMI?
Dr. Smith's ECG Blog
FEBRUARY 9, 2024
Written by Jesse McLaren A 65 year old with a history of atrial flutter, CABG and end-stage renal disease on dialysis presented with 3 days of fluctuating chest pain, which was ongoing at triage. The first ECG was labeled “anterior subendocardial ischemia”, but subendocardial ischemia does not localize. What do you think?
Dr. Smith's ECG Blog
DECEMBER 27, 2014
If it is slow Atrial flutter with 1:1 conduction, it should slow the conduction and reveal the flutter waves. This is the exact rate one expects with slow atrial flutter and it is why slow atrial flutter can be so dangerous: it conducts 1:1, with fast ventricular rates. Rate 120, flutter rate 240.
Dr. Smith's ECG Blog
JULY 16, 2024
Here I put arrows: Arrows shows slow atrial flutter waves. These mimic ST Elevation. But there is no STE. Of course the Queen knows it is not OMI: Click here to sign up for Queen of Hearts Access Here are other cases of the same: A 50 year old man with sudden altered mental status and inferior STE. Would you give lytics? Arrhythmia?
Dr. Smith's ECG Blog
JUNE 27, 2021
If this STD were due to LVH or to subendocardial ischemia, rather than posterior OMI, it would be maximal in V5 and V6. By itself these would not be diagnostic as they do not have typical morphology (flat T-waves, possible atrial repolarization wave to account for ST depression). ng/mL, and another ECG was recorded and was identical.
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