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Atrial Flutter With PVCs

Dawn's picture
Sun, 06/17/2012 - 21:48 -- Dawn

This ECG shows a nice, clear atrial flutter with 4:1 conduction.  Also, there are frequent PVCs. Good for students who have mastered the criteria for the basic arrythmias and who need to see combinations.  That is, PVCs are not only seen with NSR, and it is important to state the underlying rhythm.  For your more advanced students who understand how to plot frontal plane axis, the axis of the PVCs is nearly straight up - a very strong argument for the ventricular origin of the beats.

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Not only can you tell this is atrial flutter, the student should understand that the definative treatment for atrial flutter is mechanism specific. This example is classic "counter-clockwise isthmus dependant Right atrial flutter. It is normally treated with an ablation to the muscular isthmus between the tricuspid annulus and the inferior vena cava. This will cure it in a majority of cases. This is an exellent strip of this common rhythm.

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