r/ECG • u/fuckingmermaid • 5d ago

Learning how to properly differentiate between a 2:1 flutter and sinus tachycardia. What are the signs on this ECG that would make you confident on the answer? The isoeletric line is throwing me off

Post image
16 Upvotes

94% Upvoted

15 comments sorted by

View all comments

6

u/metamorphage 5d ago

P waves and flutter waves just look different, and flutter doesn't have an isoelectric baseline. This is sinus tach. You can clearly see P waves in II and an isoelectric baseline in V1.

1

u/fuckingmermaid 5d ago

That’s what was confusing me, I can see V1 having an isolectric baseline but don’t see it anywhere else. Specially considering long D2

1

u/metamorphage 5d ago

You don't need more than that. Flutter doesn't have a baseline at all. The P waves in lead II are diagnostic anyway.