Answer for August 19, 2013

Although the precise rate is hard to read, this is clearly a narrow complex (supracentricular) rhythm with a heart rate likely around 150. Rates around 150 are atrial flutter with 2:1 block until proven otherwise. Vagal maneuvers might increase the AV block enough to see the flutter waves. So might carotid massage. A dose of adenosine 6mg will likely reveal the flutter waves if present, or break a re-entrant supraventricular tachycardia.

NOTE: EKG's are for internal educational purposes of the University of Massachusetts Department of Family Medicine. Please do not forward without permission from Dr. Golding!

Aug 19 EKG