This week we have a rhythm strip I found.
I don't have any information on the case, patient, or management.
So what you see is what you get !
|Click to enlarge|
Two lead rhythm strip, leads II & V2, assuming standard calibration.
Three distinct rhythms:
- Ventricular Rate ~150-100 bpm
- Regular Atrial activity ~300 bpm (Flutter waves)
- Variable conduction block - 2:1 & 3:1
- No P waves
- QRS - Normal (~ 100ms)
- ST Depression lead II
- ST Elevation V2
- Abrupt termination without preceding slowing of rate, or increasing block
- Duration ~4.9 seconds
- Sinus rhythm
- Irregular due to rate change
- ~70 bpm to ~80 bpm
- PR - Normal (~160ms)
- QRS - Normal (100ms)
- QT - 400ms (QTc Bazette ~ 460 ms)
- ST Depression 1mm lead II
- ST Elevation 3-4mm lead V2
- P wave inversion V2
- Atrial flutter with variable block
- Period of aystolic pause
- Followed by sinus rhythm at appropriate rate
- ST Segment changes - ? ischaemic ? hypertrophy
- Chemical cardioversion
- Correction of underlying acid/base or electrolyte disturbance
- Sinus Node Dysfunction
References / Further Reading
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.