- Its wide > 120ms
- Its fast 150bpm
-A right bundle branch block(RBBB) is apparent in v1
-Pathological left axis deviation suggests left anterior fascicular block (LAFB)
-This would be considered a bifascicular block (RBBB & LAFB)
If you take a look at lead II & v2, the flutter waves have been marked with arrows.
ANSWER: This is a 2:1 atrial flutter with bifascicular block
Pearl: The rate around 150 is highly suggestive of 2:1 atrial flutter