ECG OF THE WEEK

By: Dr. Swathi Prof Dr. Gowrishankar’s unit

CASE 1•A 55 yr old male came with history of

palpitations for 1 day no h/o HTN/DM/CAD Pt was hemodynamically stable and systemic examn was unremarkable His ecg was taken…

ECG 1

CASE 2•A 60yr old male presented with

palpitations lasting for 3hrs h/o similar episodes twice in the past

which terminated spontaneously with restNo h/o HTN/DM/CAD

On examination: PR-130/min CVS/ RS-WNL

ECG 2

INTERPRETATION ECG 1•P wave rate-320/sec•QRS rate- 150/sec, R-R interval- irregular•QRS axis- normal•QRS duration-80 ms•Flutter ‘F’ waves seen in lead II, III ,aVF &

V1.

V1 F waves

NARROW COMPLEX TACHYCARDIA

ATRIAL FLUTTER WITH VARIABLE

BLOCK

After inj verapamil 10mg…

‘F’ waves

ECG 2•Rate-172/min•QRS duration- 100ms•Pseudo r’ seen in lead V1 & pseudo S seen

in inferior leads•Occasional bizarre QRS complexes seen•RP interval- 280ms•PR interval- 60ms

Pseudo r’

V1

II

NARROW COMPLEX TACHYCARDIA

AVNRT With phasic aberrant ventricular

conduction

After inj adenosine 6mg…

After reversion……

APPROACH TO NARROW COMPLEX

TACHYCARDIAS