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.