ECG of the Week - 4th March 2013 - Interpretation

Again no clinical information on this case.

 

 

 

 

 

Click to enlarge

Rate:

• Ventricular ~ 85 bpm
• Atrial ~ 250-300 bpm

Rhythm:

• Regularly irregular
• R-R Interval cycles from 520 ms and 960 ms

Axis:

• Normal (60 deg)

Intervals:

• PR - No p waves visible
• QRS - Normal (80-100ms)
• QT - 380ms (QTc Bazette variable due to RR irregularity)

Segments:

• ST Elevation V3 1mm
• Coincides with flutter wave superimposition

Additional:

• Flutter waves best visualised in II, III, aVF, aVL
• Positive V1
• Typical anticlockwise
• QRS alternans
• Second complex in pair slight differing voltage

Interpretation:

• Atrial flutter with variable block

References / Further Reading

 

Life in the Fast Lane

 

• Atrial flutter here

Textbook

• Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.