ECG Guru - Instructor Resources - 2:1 conducton https://www.ecgguru.com/ecg/21-conducton en Atrial Flutter With 2:1 Conduction https://www.ecgguru.com/ecg/atrial-flutter-21-conduction <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-21-conduction"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/AFL%20101.jpg" width="1799" height="1504" 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>Unfortunately, we have no clinical information on this patient, not even age or gender, as the ECG machine defaults to "Age 60". &nbsp;The rhythm is a supraventricular tachycardia at a rate of about 260/min. with 2:1 conduction, resulting in a heart rate of about 130 / minute. &nbsp;Some would call this atrial tachycardia, and some atrial flutter. &nbsp;Since the reentrant pathways involved in the two rhythms are different, it is probable that an electrophysiologist could determine the exact location of the pathway in the EP lab. &nbsp;Without benefit of this test, we use our best guess. &nbsp;We will leave it to our more advanced Gurus to debate the origins of this rhythm.</p><p>The fast P waves are best observed in the limb leads, with one P wave occuring in the QRS complex. &nbsp;If you ignore the QRS complexes for a moment, you can draw an unbroken line through them, uncovering the flutter waves. &nbsp;SVTs with 2:1 conduction can easily be mistaken for sinus tachycardia. &nbsp;Always suspect and look for atrial flutter when the heart rate is around 150 / minute. &nbsp;A 12-lead is a big help, as flutter waves show up better in some leads than in others. &nbsp;Another way to uncover atrial flutter is to slow the rate with vagal maneuvers or medication to decrease the conduction ratio, and observe several flutter waves in a row without QRS complexes.</p><p>Of even more concern to this patient may be the ST elevations - slight but noticeable - in Leads V2 - V4, and possibly I and aVL. &nbsp;The J points (the beginning point of the ST segment) can be obscurred by the P wave lying beneath the QRS, and it may be difficult to judge ST elevations.</p><p>We expect this ECG to elicit many opinions - possibly different from ours. &nbsp;Please add your comments below. &nbsp;We will enjoy the discussion.</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/392/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 2:1 Conduction 1/5</option><option value="40">Give Atrial Flutter With 2:1 Conduction 2/5</option><option value="60">Give Atrial Flutter With 2:1 Conduction 3/5</option><option value="80">Give Atrial Flutter With 2:1 Conduction 4/5</option><option value="100" selected="selected">Give Atrial Flutter With 2:1 Conduction 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >4.6</span></span> <span class="total-votes">(<span >5</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-9bP0USGUqLreVc-LT9UvUAuacUfdmEQoCnZFFWTPKgA" /> <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/atrial-tachycardia" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Atrial tachycardia</a></div><div class="field-item even"><a href="/ecg/21-conducton" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">2:1 conducton</a></div><div class="field-item odd"><a href="/ecg/tachycardia" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Tachycardia</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-21-conduction&amp;title=Atrial%20Flutter%20With%202%3A1%20Conduction"><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> Sat, 05 Oct 2013 05:07:15 +0000 Dawn 502 at https://www.ecgguru.com https://www.ecgguru.com/ecg/atrial-flutter-21-conduction#comments