VEBs Interrupting Flutter Bigeminy

Report:

Atrial flutter (tachycardia) 208/min

Alternating 4:1 & 2:1 block

VEBs (one premature and one escape - fusion - beat)

Comment:

One and a half supraventricular beats are replaced! The fusion beat counts as only half-replaced. One would also be acceptable answer. Two would not.

It was a trick question, justified by promoting some basic understanding of atrio-ventricular relationship and relieving the tædium of routine reporting.

The flutter shows its classical bigeminy, due to a proximal 2:1 AV block combination with distal 3:2 block.

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