Atrial Flutter Ischemia Tachycardia 
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. Tachycardia and ST Elevation. Atrial Flutter with Inferior STEMI?
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.
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
JULY 16, 2024
Here I put arrows: Arrows shows slow atrial flutter waves. The problem is, that the PR interval of the upright deflection in lead II ( under the RED arrows ) is relatively long ( clearly more than 1 large box in duration ) — and if anything, the PR interval should shorten when there is tachycardia. These mimic ST Elevation.
Dr. Smith's ECG Blog
MARCH 6, 2020
Here was his ED ECG: There is sinus tachycardia (rate about 114) with nonspecific ST-T abnormalities. There is a large peaked P-wave in lead II (right atrial enlargement) There is left axis deviation consistent with left anterior fascicular block. There is no evidence of infarction or ischemia. So what is it?
Dr. Smith's ECG Blog
OCTOBER 25, 2022
We see a regular tachycardia with a narrow QRS complex and no evidence of OMI or subendocardial ischemia. The differential of a regular narrow QRS tachycardia is sinus tachycardia, SVT, and atrial flutter with regular conduction. There are no P waves preceding the QRS complexes, and no clear flutter waves.
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