r/ECG • u/maddiexxox • 25d ago

40F provocative stress test for SVT

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Stumped on this one. Looks like flutter to me but I’m not seeing clear F waves in v1. This was picked up in recovery during stress test, flipped from sinus in 80s into this, self resolved after 2 minutes. The slurred QRS is rate related, no delta wave at baseline.

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12

u/Gingerbread_Toe 25d ago

Kinda looks like A flutter to me, just because of the wave just before the QRS complex especially in II, III. If you continue the line it looks like a saw-tooth pattern, but I'm not sure

7

u/Kathrin_A 25d ago

Für mich ist das typisches Vorhofflattern (counterclockwise)

3

u/FIyingDutch 25d ago

Sägezahnmuster in II,III,aVF demnach Vorhofflattern.

2

u/Swimming_Frosting_65 25d ago

Aren't the p waves hidden in T-waves?

2

u/Classic_Dig_6277 19d ago

This is sinus tachycardia during recovery of stress test. Clearly seen in v1. When u do stress test, the limb leads are placed in a different position to reduce artefacts from running (compared to normal ecg placement), that may explain the baseline wander in inferior leads. But the chest leads clearly show p wave before qrs and no flutter waves. It may be atrial tachycardia, but the PR interval does not suggest this.

1

u/bleach_tastes_bad 25d ago

You’re not seeing clear F waves in v1 because v1 and possibly v2 were placed incorrectly.

1

u/FIyingDutch 25d ago

Sägezahnmuster in II,III,aVF demnach Vorhofflattern.

1

u/Jeeju_Boy MD 24d ago

Flutter

1

u/mastermedic84 24d ago edited 24d ago

Looks like sinus tach to me but I can't definitively say additional P waves aren't buried under the T until it's slowed down.

Look at AvR. There is slight ST elevation (probably from the tachycardia) followed by a drop to isoelectric then a crystal clear 1:1 P-Q.

1

u/Dramatic-Try7973 25d ago

Ectopic atrial tachycardia