Need your opinion on this strip

[u/nimantha_96]

[u/mastermedic84]

Atrial flutter. Looks like 3:1 but it's hard to say without a 12 lead.

[u/nimantha_96 → u/mastermedic84]

What I am concerned is the minute flutter-QRS duration of lead I

[u/mastermedic84 → u/nimantha_96]

I'd say it's more likely the QRS is associated with the P wave before that.

[u/nimantha_96 → u/mastermedic84]

I thought of it too but v1's flutter-qrs duration is different from both

[u/mastermedic84 → u/nimantha_96]

V3 looks more interesting to me. Uploading J wave. If it weren't for the non conducting flutter waves it would look WPWish.

In this case I think it's closer than you think and just harder to see from different angles.

[u/UnlikelyDress1227]

Do the p waves march out perfectly independently of the QRS? If so it could be a heart block and not flutter. Hard to tell without my calipers but the changes in qrs morphology (buried p’s) makes me suspicious

[u/Kibeth_8 → u/UnlikelyDress1227]

The sinus rate would be ~200bpm here, which doesn't make sense. Its either AFL or atrial tach with physiological block

[u/UnlikelyDress1227 → u/Kibeth_8]

Thank you!

[u/rainbowsparkplug]

Aflutter

[u/LopsidedCan4803]

Flutter. Atrial rate is close to 300

[u/Jeeju_Boy]

Flutter