This ECG was obtained from a patient in a walk-in health clinic. We do not have any other information on the patient. We thank Joe Kelly for donating this interesting ECG to the GURU.
This series of strips was donated by Arnel Carmona, and was taken from a patient admitted to the hospital for a urinary tract infection. No other history is known. On close examination of this rhythm what do we see?
Strip 1: Narrow-complex tachycardia with NO apparent P waves.
Strip 2: Some irregularity, with long regular groups and still NO P waves.
This very interesting set of strips was donated to the ECG Guru by Arnel Carmona, well-known to many of you as the Administrator of the blog, "ECG Rhythms" and the FB page by the same name. He is a frequent contributer to the FB page, "EKG Club", and is an ECG Guru! This set of strips was previously posted to his blog and to the EKG Club.
This ECG provides an example of atrial flutter with variable conduction. There are two distinct R - R intervals, making this a somewhat regularly-irregular rhythm, as opposed to the irregular irregularity of atrial fibrillation. The flutter waves (P waves) are very easy to see in most leads, but not in all. If you are teaching students who are making the transition from reading monitors and rhythm strips to 12-lead ECGs, this is a great ECG to illustrate for them how the more leads you have, the more you will see.
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