Atrial Flutter Ischemia Tachycardia 
Dr. Smith's ECG Blog
JANUARY 9, 2024
She had a single chamber ICD/Pacemaker implanted several years prior due to ventricular tachycardia. The ECG was interpreted as showing atrial flutter with 2:1 conduction. Are you confident there is no ischemia? Answer : The ECG above shows a regular wide complex tachycardia. The ECG below was recorded. Is this: 1.
Dr. Smith's ECG Blog
SEPTEMBER 17, 2021
So it is not atrial fib and not VT. It is a regular narrow complex tachycardia. There is a lot of ST depression -- this is ischemia caused by the very fast rate and is an indication for emergent electrical cardioversion. If you look closely at lead II across the bottom, it appears there are flutter waves. What is the DDx?
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 27, 2014
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. Rate 120, flutter rate 240. ACS is of course possible. Still more ST depression.
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. Tachycardia and ST Elevation. Atrial Flutter with Inferior STEMI?
Ken Grauer, MD
MARCH 23, 2023
At about this point in the process — I like to take a closer LOOK at the 12-lead tracing, to ensure there is no acute ischemia or infarction that might need immediate attention. PEARL # 3: At this point — the most time-efficient step for solving today's rhythm will be to determine the nature of atrial activity.
Dr. Smith's ECG Blog
AUGUST 3, 2018
There is a narrow complex tachycardia at a rate of 130. ECGs: there is a regular narrow complex tachycardia still at a rate of exactly 130, with no P-waves and also no change since the prehospital ECG. Leads II and aVF appear to have flutter waves. I diagnosed atrial flutter with 2:1 conduction. Is is sinus?
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