ID 122 – 50 year old man complaining of palpitation
ID 122 – 50 year old man complaining of palpitation Can you see P waves?
ID 122 –  Atrial flutter with variable AV block – Ventricular rate 107/min.  We can see  typical waves of atrial flutter  with variable AV block –  ventricular rate = 107/min.
ID 122 –  Atrial flutter with variable AV block – Ventricular rate 107/min.  Let’s now look at the QRS complexes: The QRS complex is positive in I and its average is slightly positive or isoelectric in aVF – The QRS is normal
ID 122 –  Atrial flutter with variable AV block – Ventricular rate 107/min.  The QRS duration is normal – There are no signs of right or left bundle branch block  Or nonspecific block
ID 122 –  Atrial flutter with variable AV block – Ventricular rate 107/min.  There no signs of right or left ventricular hypertrophy
ID 122 –  Atrial flutter with variable AV block – Ventricular rate 107/min.  The QRS shows no signs of myocardial infarction
ID 122 –  Atrial flutter with variable AV block – Ventricular rate 107/min.  Because of the saw-like waves of atrial flutter, it is difficult to assess the T waves in the Inferior leads  and V6. In the other leads the T waves are normal.
ID 122 -  Final diagnosis  - Atrial flutter with variable AV block – Ventricular rate 107/min.  Because of the saw-toothed  waves of atrial flutter, it is difficult to assess the T waves in the inferior leads  and V6. In the other leads the T waves are normal.

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Stepwise interpretation of ECG ID122

  • 1. ID 122 – 50 year old man complaining of palpitation
  • 2. ID 122 – 50 year old man complaining of palpitation Can you see P waves?
  • 3. ID 122 – Atrial flutter with variable AV block – Ventricular rate 107/min. We can see typical waves of atrial flutter with variable AV block – ventricular rate = 107/min.
  • 4. ID 122 – Atrial flutter with variable AV block – Ventricular rate 107/min. Let’s now look at the QRS complexes: The QRS complex is positive in I and its average is slightly positive or isoelectric in aVF – The QRS is normal
  • 5. ID 122 – Atrial flutter with variable AV block – Ventricular rate 107/min. The QRS duration is normal – There are no signs of right or left bundle branch block Or nonspecific block
  • 6. ID 122 – Atrial flutter with variable AV block – Ventricular rate 107/min. There no signs of right or left ventricular hypertrophy
  • 7. ID 122 – Atrial flutter with variable AV block – Ventricular rate 107/min. The QRS shows no signs of myocardial infarction
  • 8. ID 122 – Atrial flutter with variable AV block – Ventricular rate 107/min. Because of the saw-like waves of atrial flutter, it is difficult to assess the T waves in the Inferior leads and V6. In the other leads the T waves are normal.
  • 9. ID 122 - Final diagnosis - Atrial flutter with variable AV block – Ventricular rate 107/min. Because of the saw-toothed waves of atrial flutter, it is difficult to assess the T waves in the inferior leads and V6. In the other leads the T waves are normal.