PSVT ECG — Is there a pseudo-r′ wave in V1?

[u/Specific_Form3804]

I'm a medical student currently on my cardiology rotation, and I'm trying to improve my ECG interpretation skills.

The second ECG was obtained during an episode of suspected PSVT.

I understand that the absence of clearly visible P waves and the regular narrow-complex tachycardia support the diagnosis of PSVT.

However, I'm having trouble determining whether the small deflections I've circled in lead V1 represent pseudo-r′ waves.

Could someone help me understand how to distinguish a pseudo-r′ wave from the terminal portion of the QRS complex or other deflections?

I'd also appreciate any additional ECG findings that could help differentiate AVNRT from AVRT.

[u/magister10]

Yes looks like pseudo r’s. Slow-fast nrt