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A 78 yo patient male presents with palpitations. He has no chest pain or shortness of breath. His heart rate is 138bpm and he was haemodynamically stable. His ECG is shown.
​Describe and interpret the ECG.


The diagnosis is atrial flutter.
Do you know how to pick it?
​Do these patients need anticoagulation?

One Comment

  • Marin says:

    Hi Peter,

    Thank you very much for another interesting ECG.
    May I notice that heart rate is around 150 rather than 137 as stated in introduction to this case.
    Regular Narrow complex tachycardia at rate of around 150 at that age group is often Atrial Flutter.
    I can not see any typical flutter appearance in initial ECG.
    Was he initially given trial of Adenosine which revealed Atrial Flutter 2:1 or he was electrically cardioverted straight away ?

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