Careful measurement will show that this QRS is very slightly early, while the others are all very regular. This probably represents aberrant conduction, possibly a hemiblock that occurs only in this beat. This beat is about the same width as the other QRS complexes, but is opposite in direction. There is one beat that is obviously different from the others. Multiple leads can more easily uncover the flutter waves running continuously "behind" and "through" the QRS complexes. This rhythm could also be mistaken for atrial tachycardia or other forms of supraventricular tachycardia (SVT, PSVT, AVNRT, etc.). It can masquerade as sinus tach, but a patient with sinus tach at such a fast rate would probably have an obvious cause for a rapid heart rate, such as hypovolemia, drug overdose, or exertion. Since atrial flutter results in atrial depolarization at around 250 - 350 per minute, conducting every other P wave results in a rate of about 150. ![]() Whenever the ventricular rate is near 150/min., we should always consider the possibility of atrial flutter with 2:1 conduction. The P waves (or flutter waves) here have a sharp point, and can be easily "marched out", with a rate of about 300 per minute. We ALWAYS recommend multi-lead assessment for such evaluation. ![]() It is somewhat difficult to evaluate the baseline for P waves or flutter waves. It shows a regular tachycardia with a slightly-widened QRS complex at about. This strip was taken from a patient at rest.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |