Arrhythmias (IV)

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Arrhythmias (IV)


What rhythm does this tracing show?


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Answer: Atrial flutter with mostly 2:1 and occasional 3:1 atrioventricular (AV) conduction
Discussion
This tracing shows a narrow QRS tachycardia at a rate of 138 bpm, which is highly suggestive of atrial flutter with 2:1 AV conduction. This is proven by the fact that when there is 3:1 AV conduction toward the end of the tracing, intact flutter waves are readily recognizable. In V1, there are regularly occurring P waves at a rate of 280 bpm, further supporting this diagnosis.



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