ECG Guru - Instructor Resources - Rate-dependent RBBB https://www.ecgguru.com/ecg/rate-dependent-rbbb en Atrial Flutter With 1:1 Conduction and Rate-dependent Right Bundle Branch Block https://www.ecgguru.com/ecg/atrial-flutter-11-conduction-and-rate-dependent-right-bundle-branch-block-0 <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/atrial-flutter-11-conduction-and-rate-dependent-right-bundle-branch-block-0"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/SVTRB100_0.jpg" width="2022" height="1133" alt="" /></a></div><div class="field-item odd"><a href="/ecg/atrial-flutter-11-conduction-and-rate-dependent-right-bundle-branch-block-0"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/SVTRB100B_2.jpg" width="1800" height="1453" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>The first ECG is from an active, otherwise healthy 66-year-old man who experienced a sudden onset of symptomatic tachycardia. He presented to the Emergency Dept. feeling (understandably) very anxious, with poor perfusion to his skin, chest discomfort, and palpitations. As the ED staff prepared to electrically cardiovert him, he spontaneously converted to normal sinus rhythm at a rate of 93 / min. and a QRS duration of 90 ms.</p><p>After a normal diagnostic cardiac cath, he was sent to the EP lab and the&nbsp;circuit responsible for this rhythm was successfully ablated. He was discharged in good condition the next day.</p><p>This is a good ECG for all levels of students. For beginners, it shows that atrial flutter is one of the rhythms we call "SVT", and it does not always conduct in a variable rate, or a rate that allows "sawtooth" P waves to show easily. You can show them that the "sawtooth" pattern, brought about by P waves that are 250 - 350 per minute, is still there if one ignores the QRS complexes for a moment. This is a great ECG for discussions of rate and cardiac output, and making decisions regarding treatment based on the patient's hemodynamic condition. For more advanced students, this ECG can lead to a discussion of the accessory pathways and re-entrant pathways that cause rapid rhythms. For RBBB criteria, click <a title="Rt Bundle Branch Block" href="http://www.ekgguru.com/node/45"><span style="text-decoration: underline;"><span style="color: #0062a0;">HERE</span></span></a>.</p><p>The second ECG shows the same patient after spontaneous conversion to sinus rhythm.&nbsp; The bundle branch block has disappeared, as it was rate-dependent.</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/241/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Atrial Flutter With 1:1 Conduction and Rate-dependent Right Bundle Branch Block 1/5</option><option value="40">Give Atrial Flutter With 1:1 Conduction and Rate-dependent Right Bundle Branch Block 2/5</option><option value="60">Give Atrial Flutter With 1:1 Conduction and Rate-dependent Right Bundle Branch Block 3/5</option><option value="80" selected="selected">Give Atrial Flutter With 1:1 Conduction and Rate-dependent Right Bundle Branch Block 4/5</option><option value="100">Give Atrial Flutter With 1:1 Conduction and Rate-dependent Right Bundle Branch Block 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.5</span></span> <span class="total-votes">(<span >2</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-1CRmdNF1TK9RL31OLaZe-2fCcBKwebU6ONtm381f344" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/atrial-flutter-0" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Atrial flutter</a></div><div class="field-item odd"><a href="/ecg/right-bundle-branch-block-1" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Right bundle branch block</a></div><div class="field-item even"><a href="/ecg/rate-dependent-rbbb" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Rate-dependent RBBB</a></div><div class="field-item odd"><a href="/ecg/rbbb" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">RBBB</a></div><div class="field-item even"><a href="/ecg/bundle-branch-block" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Bundle branch block</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fatrial-flutter-11-conduction-and-rate-dependent-right-bundle-branch-block-0&amp;title=Atrial%20Flutter%20With%201%3A1%20Conduction%20and%20Rate-dependent%20Right%20Bundle%20Branch%20Block"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Tue, 20 Mar 2012 01:40:36 +0000 Dawn 195 at https://www.ecgguru.com https://www.ecgguru.com/ecg/atrial-flutter-11-conduction-and-rate-dependent-right-bundle-branch-block-0#comments