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Ignoring the first half complex...

Complex 1, 2, and 3 are equal in duration.

The distance between complex 4, and 5 is the same as between 2, and 4

Complexes 5, 6, and 7 are equal in duration, but longer than complexes 1, 2, and 3

Can't see any pattern to complexes 8, 9, 10, 11, or 12

No discernable p-waves (anything which may be assumed to be P-waves are not repeated subsequently in a similar morphology) narrow QRS, and irregular rhythm which possibly, just possibly, has a degree of repitition to it, though no apparent predictable trends are noticeable. Otherwise, irregularly irregular.

A-fib till proven otherwise

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The rule I think has been the hardest for me to accept is basically that any irregular rythm with no p-waves and basically normal QRS is afib. Until I caved in I missed similiar EKG's on multiple exams. Definitly try to get a longer strip and eliminate artifact if possible, but for exam purposes most books etc I have seen will call similiar afib. Sorry not more help.

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What's that saying, that if you show a strip to 5 different cardiologists, you'll get 6 different answers... :mrgreen:

Added: My first inclination was to call it A-fib...but it is regularly irregular. Maybe controlled? My guess would be maybe some a-fib/flutter with a block of some sort. If you look between the first 1/2 beat and the first full one, there are 3 little bumps that could be flutter waves? It occurs again between beats 4 and 5, but then there are 5 bumps. [s:5230eb3d5a]Maybe the Pt's pleasure... :shock[/s:5230eb3d5a]: HPV?

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I think the idea of flutter with fib as well is probably the best option with the given strip.

I think the moral of the story is that this isn't the best example of a-fib to put in an "introduction to rhythm interpretation" booklet. :)

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  • 3 weeks later...

Irregular, no P waves...AF. I agree with turning up the gain in case P waves could be hidden, but sort of doubt it.

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