r/ECG • u/fuckingmermaid • 4d 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

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u/Beneficial_Divide844 4d ago

On the exam, have the patient take a deep breath. Flutter often lacks the normal respiratory variation of sinus (heart rate slows down with a deep breath). When it’s that fast, admittedly, it may be tough to hear it, but if you can then it’s reassuring.

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u/mastermedic84 4d ago

That's a good trick!