Wednesday, 6 June 2012

ECG of the Week - 4th June 2012 - Interpretation

This weeks ECG is another from last weeks patient following 5mg metoprolol.




Click to enlarge

Rate:
  • 102
Rhythm:
  • Regular
Axis:
  • Normal (+30 deg)
Intervals:
  • PR - flutter waves visible
  • QRS - Normal (80ms)
  • QT - 320ms (QTc Bazette ~ 410 ms)
Segments:
  • Nil abnormalities
Additional:
  • Notching of flutter waves in lead II, III, aVF, V3-4
  • Evidence of atrial activity best seen in inferior leads
  • Suggestion of atrial activity buried in the terminal portion of the QRS


Interpretation:

  • Flutter 2:1 block as per previous ECG more apparent due to beta-blockade

References / Further Reading


Life in the Fast Lane

  • Atrial Flutter here
Textbook
  • Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.