Ventricular Flutter

Report:

Top:

Ventricular flutter 300/min

Middle:

Accelerated idioventricular (?junctional) rhythm 78/min

Sinus capture beats

Probable AV dissociation

Bottom:

Atrial tachycardia 113/min

Comment:

In ventricular flutter, the distinction between QRS, ST segment and the T wave is lost in a series of uniform, usually large, deflections at rates between 250 and 350/min. The terminology of very fast ventricular rhythms remains somewhat confused42.

The monitor lead gain should be adjusted to allow the entire complex to be seen. Below is a segment where the QRS is clearly too large. Does it matter? It may: subtle evidence of fusion or cycle length change may be missed.

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