A place for the emergency clinician to procrastinate, discriminate, evaluate, emulate, & educate.
Interesting rhythm. I expect that it isn't making the patient too symptomatic, since the ventricular rate is about 80.
I agree, just hope they are maintaining some cardiac output.
Is that 4:1 or 3:1 ? I can only count 3 flutter waves between each QRS...
4:1, there is a flutter wave buried in the QRS, one buried in the T-waves, and two prior to each QRS.Adam
That is amazing. I would not have considered the one buried in the T-waves, though that might explain their morphology.
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.
This is a case of 4:1 atrial flutter. 
Interesting rhythm. I expect that it isn't making the patient too symptomatic, since the ventricular rate is about 80.
ReplyDeleteI agree, just hope they are maintaining some cardiac output.
ReplyDeleteIs that 4:1 or 3:1 ? I can only count 3 flutter waves between each QRS...
ReplyDelete4:1, there is a flutter wave buried in the QRS, one buried in the T-waves, and two prior to each QRS.
ReplyDeleteAdam
That is amazing. I would not have considered the one buried in the T-waves, though that might explain their morphology.
ReplyDeleteAnytime 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.
ReplyDelete