EKG Basics and Interpretation - part 3 potx

Atrial Flutter • Regular atrial activity with a "clean" saw-tooth appearance in leads II, III, aVF, and usually discrete 'P' waves in lead V1. The atrial rate is usually about 300/min, but may be as slow as 150-200/min or as fast as 400-450/min. • Untreated A-flutter often presents with a 2:1 A-V conduction ratio. This is the most commonly missed supraventricular tachycardia because the flutter waves are often difficult to find when there is 2:1 ratio. • The ventricular response may be 2:1, 3:1, 4:1, or irregular depending upon the AV conduction properties and AV node slowing drugs on board [...]... Advanced heart disease statistically favors VT – Cannon 'a' waves in the jugular venous pulse suggests VT with AV dissociation – If the patient is hemodynamically unstable, think VT and act accordingly • ECG clues for example Bruganda criteria . saw-tooth appearance in leads II, III, aVF, and usually discrete 'P' waves in lead V1. The atrial rate is usually about 30 0/min, but may be as slow as 15 0-2 00/min or as fast as 40 0-4 50/min beat, and the arrhythmia also stops abruptly - which is why they are called paroxysmal. They are usually narrow-QRS tachycardias unless there is preexisting bundle branch block or rate-related. Tachycardia • Discrete, multifocal P' waves occurring at rates of 10 0-2 50/min and with varying P'R intervals (should see at least 3 different P wave morphologies in a given lead) • Ventricular