Strip Tease 11: Answer

By definition this is a Wide Complex Tachycardia (WCT)

• 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