Atrial flutter EKG examples: Difference between revisions
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Shown below is an electrocardiogram of a patient being treated with an external cardioverter/defibrillator for atrial flutter. The patient is under general anesthesia and two shocks were given, the first at 50 joules and the second at 100 joules. | Shown below is an electrocardiogram of a patient being treated with an external cardioverter/[[defibrillator]] for atrial flutter. The patient is under [[general anesthesia]] and two shocks were given, the first at 50 joules and the second at 100 joules. | ||
[[Image:Atrial Flutter.jpg|center|800px]] | [[Image:Atrial Flutter.jpg|center|800px]] | ||
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:E00031671.jpg | Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:E00031671.jpg |
Revision as of 17:22, 23 October 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
For the main page on atrial flutter, click here.
Atrial flutter EKG examples
Shown below is an electrocardiogram of a 2:1 atrial flutter.
![](/images/6/69/AtrialFibrillation2to1Conduction.jpg)
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:ECG_Aflutt.jpg
Shown below is an electrocardiogram of a 3:1 atrial flutter.
![](/images/1/1d/AFLUTTER3.1.jpg)
Shown below is an electrocardiogram of a 4:1 atrial flutter.
![](/images/6/66/AFLUTTER4.1.jpg)
Shown below is an electrocardiogram of atrial flutter with right bundle branch block demonstrated by Rsr' pattern in leads V1, V2, and V3.
![](/images/b/b7/AFLUTTER.RBBB.jpg)
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/Main_Page
Shown below is an electrocardiogram of an 82 year old man with a history of lung disease and renal failure. At the time of this recording the patient was on iron, lasix, and bronchodilators. The EKG shows a regular rhythm at a rate of 141/min. This patient had been in atrial fibrillation in the past and the rhythm here is probably atrial flutter with 2:1 block although no flutter waves are seen. The QRS duration is widened at 105 ms and the tall R waves in V5 and S waves in V1 and V2 and the ST depression in the absence of digoxin suggest left ventricular hypertrophy. The QRS is too narrow for ventricular tachycardia and the brief R wave in V2 with the clean down-stroke of the V2 S wave argue against a ventricular origin. The patient was placed on digoxin with a slowing of the ventricular rate and a rhythm that was clearly atrial fibrillation and with a QRS with the same morphology.
![](/images/4/4b/Atrial_flutter_in_afib.jpg)
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:E338.jpg
Shown below is an electrocardiogram of a patient being treated with an external cardioverter/defibrillator for atrial flutter. The patient is under general anesthesia and two shocks were given, the first at 50 joules and the second at 100 joules.
![](/images/2/21/Atrial_Flutter.jpg)
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:E00031671.jpg
The cardiogram show spontaneous termination of atrial flutter. The flutter waves can be seen deforming the QRS especially in leads II and III.
![](/images/9/91/Atrial_flutter_termination1.jpg)
The recording below shows the spontaneous termination of atrial flutter. The termination occurs just at the first lead switch (e.g. lead I to aVR). Note that the QRS does not change but is deformed by the large flutter waves that are running at a rate of about 300/min. The QRS voltages (minus the flutter waves) is low in the precordial leads (< 5 mm).
![](/images/9/94/Atrial_flutter_termination2.jpg)
The rhythm below is atrial flutter with flutter waves seen best in the inferior leads and in leads V1 to V3. The atrial rate is about 250/min. The QRS is wide (>120ms) an there is a tall R' wave in V1 and a shallow S in V6. The axis of the QRS seems normal. The EKG shows a right bundle branch block.
![](/images/1/17/Atrial_flutter_and_RBBB.jpg)
Shown below is an example of EKG showing atrial tachycardia at about 240/min. (slow atrial flutter?) with 2:1 A/V block. The atrial activity is best seen in leads V1, III and aVF.
![](/images/8/8c/2to1AVBlock2.jpg)
Shown below is an electrocardiogram of an atrial flutter in a patient with WPW syndrome. There is 1:1 conduction down a bypass tract.
![](/images/d/d0/Atrial_Flutter_with_WPW.jpg)
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:ECG_Aflutt_1to1.jpg