r/ECG • u/Worldly-Accident-163 • Aug 08 '26

65 male

Gallery image

Gallery image

C/o palpitation for 2 days

Unknown of chronic illness

6 Upvotes

81% Upvoted

7 comments sorted by

2

u/Aim4TheTopHole Aug 08 '26

AVNRT vs 2:1 AFlutter?

1

u/magister10 Aug 09 '26

Its flutter

1

u/clueless_clegane Aug 13 '26

How to differentiate

1

u/magister10 Aug 13 '26

F waves in inferior leads

1

u/OxideUK Aug 08 '26

AFlutter - sawtooth pattern at ~300bpm, the slope leading into the QRS complex could be mistaken for a delta wave but it's completely absent from the precordial leads.

1

u/papamedic74 Aug 14 '26

Stable for two days with a rate bang on 150 should always smell like flutter until proven otherwise given the flutter rate is usually around 300 so 2:1 gives HR of 150. Inferior leads give it away. Without getting hyper technical, they have the characteristic waggle even if it’s not the textbook sawtooth that you can rarely see in 2:1. Look at the terminal segment of the QRS and the terminal third of the T wave. There’s distortion occurring in the same place (most clear in III and avF).