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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