4:1 Atrial Flutter



This is a case of 4:1 atrial flutter.

Patient presentation is unknown.



Blue arrows indicate T-waves

Red/Yellow arrows indicate R-R intervals

6 comments:

Rogue Medic said...

Interesting rhythm. I expect that it isn't making the patient too symptomatic, since the ventricular rate is about 80.

Adam Thompson, EMT-P said...

I agree, just hope they are maintaining some cardiac output.

Anonymous said...

Is that 4:1 or 3:1 ? I can only count 3 flutter waves between each QRS...

Adam Thompson, EMT-P said...

4:1, there is a flutter wave buried in the QRS, one buried in the T-waves, and two prior to each QRS.

Adam

Shaggy said...

That is amazing. I would not have considered the one buried in the T-waves, though that might explain their morphology.

Adam Thompson, EMT-P said...

Anytime you are considering a-flutter, I have found it is helpful to trace out the F-waves. If you do this, keeping your F-F interval consistent, it is easy to see where the all are. It also makes that sawtooth patter stand out.