Atrial Flutter

Lead II

 

12-Lead

Flutter with variable block2

 

Interpretation Rules

  • Narrow complex tachycardia
  • Regular atrial activity at ~300 bpm
  • Flutter waves  (“saw-tooth” pattern) best seen in leads II, III, aVF  —  may be more easily spotted by turning the ECG upside down!
  • Flutter waves in V1 may resemble P waves
  • Loss of the isoelectric baseline
  • Narrow complex tachycardia at 150 bpm (range 130-170)? Yes -> Suspect flutter!

 

Fixed AV blocks

  • 2:1 block = 150 bpm
  • 3:1 block = 100 bpm
  • 4:1 block = 75 bpm
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