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Typical atrial flutter is recognized on an electrocardiogram by the presence of characteristic "flutter waves" at a regular rate of 250 to 350 beats per minute. Flutter waves may not be evident on an ECG in atypical forms of atrial flutter.
Some atrial tachycardias, rather than being a result of increased automaticity may be a result of a micro-reentrant circuit (defined by some as less than 2 cm in longest diameter to distinguish it from macro-reentrant atrial flutter). Still other atrial tachycardias may be due to triggered activity caused by after-depolarizations. [19]
P-wave changes in left and right atrial hypertrophy. Bifid P waves (known as P mitrale) indicate left-atrial abnormality - e.g. dilatation [6] or hypertrophy. [1] If at least three different shaped P waves can be seen in a given ECG lead tracing, this implies that even if one of them arises from the SA node, at least two others are arising ...
Another variation on this concept is seen in atrial flutter. As a result of the rapid atrial rate, some of the atrial activity fails to get through the AV node in an antegrade direction but can alter the rate at which a subsequent atrial impulse is conducted. In this circumstance, an alteration in the F-wave to QRS relationship is seen.
Ventricular flutter is an arrhythmia, more specifically a tachycardia affecting the ventricles with a rate over 250-350 beats/min, and one of the most indiscernible. It is characterized on the ECG by a sinusoidal waveform without clear definition of the QRS and T waves.
Electrode placement for Lewis lead; RL electrode (green), not shown, remains on leg . A Lewis Lead (also called the S5 lead) is a modified ECG lead used to detect atrial flutter waves when atrial flutter is suspected clinically, based on signs and symptoms, but is not definitely demonstrated on the standard 12 lead ECG.
A wandering atrial pacemaker can be either normal or irregular in rate, much like a sinus arrhythmia the rate is normally between 60 - 100 bpm when it is normal and less than 60 when it is slow, the distinguishing feature of this rhythm is a p wave that varies in size, shape, and direction, the PR interval can either be normal or irregular ...
This ECG from the same patient shows atrial fibrillation at around 126 beats per minute. The most common complication of sinus node dysfunction is the development of tachycardia-bradycardia syndrome with abnormal atrial rhythms such as atrial tachycardia, atrial fibrillation, and flutter.