article thumbnail

A young woman with palpitations. What med is she on? With what medication is she non-compliant? What management?

Dr. Smith's ECG Blog

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.

article thumbnail

Physiology Friday #228: Identifying Sleep Patterns that Influence Chronic Disease Risk

Physiologically Speaking

Welcome to the Physiology Friday newsletter. Physiologically Speaking is a reader-supported publication. This irregular sleep pattern misaligns circadian rhythms and disrupts physiology. Deep sleep: Each percent increase in deep sleep was associated with a lower risk of atrial fibrillation, depression, and anxiety.

article thumbnail

A 50 year old man with sudden altered mental status and inferior STE. Would you give lytics? Yes, but not because of the ECG!

Dr. Smith's ECG Blog

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?

article thumbnail

Arrhythmia? Ischemia? Both? Electricity, drugs, lytics, cath lab? You decide.

Dr. Smith's ECG Blog

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. If so, why?

article thumbnail

Cardiomatics guide: Analyzing arrhythmias made easy

Cardiomatics

Then, the current flows to an area known as the bundle of His, which divides into two branches (LBB and RBB) and is the only physiological pathway connecting the atria with the ventricles. AFIB/AFL – atrial fibrillation or atrial flutter episodes. The left bundle and right bundle terminate in the Purkinje fibers.

article thumbnail

A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

Dr. Smith's ECG Blog

The ECG was interpreted as showing atrial flutter with 2:1 conduction. The heart rate could be compatible with that of a 2:1 conducted atrial flutter. Also, lead I could give the initial impression of showing flutter waves. The patient’s own underlying atrial rhythm is revealed at a heart rate in the mid 50s.

article thumbnail

ECG Blog #409 — Every-Other-Beat.

Ken Grauer, MD

The other leads that most often manifest readily identifiable 2:1 atrial activity — are leads aVR , V1 and/or V2 — so I favor first checking out these 6 leads whenever looking for AFlutter. ECG #3 was obtained during treatment of this patient's AFlutter — at approximately the same time that ECG #1 was obtained.

Blog 176