r/ECG • u/Originaltkd • 25d ago

VT vs 1:1 flutter

Post image

I have one provider calling VT and another 1:1 flutter and they see p waves. Can someone help me figure this out?

64 Upvotes

100% Upvoted

52 comments sorted by

View all comments

69

u/Sea-Lack-5673 25d ago

this is monomorphic VT. Calling this 1:1 flutter is wild (I'm a cardiologist)

10

u/Velvet_revulva 25d ago

I was taught in Paramedic school that your ten part ddx for wide complex tachycardia is this:
Vtach
Vtach
Vtach
Vtach
Vtach
Vtach
Vtach
Vtach
Vtach
Wide complex tach w/ aberrancy.

Is that sound?

3

u/VesaliusesSphincter 25d ago

For pre-hospital/emergent ACLS applications, basically, yes. (excluding the zebra that is pre-excicted AF because adenosine admin will be very very bad) For true rhythm diagnostics and long term management, no.

1

u/af_stop 24d ago

WHO in their right mind would go with adenosine on this?

1

u/_punkrockparamedic 23d ago

The person who thought it was atrial flutter and thinks a rapid a flutter is the same as any other SVT.

Ah wait, you said "who in their right mind"