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Odd EKG, any suggestions?


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I'v been a medic for nearly 20 years, but I ran across a rhythm recently that I can't really identify. At first glance It looks like a A fib with bradycardia, rate in the 40s to 50s. But there are definite P waves, which are irregular, and seem to march through the complexes. The QRS complexes are are irregular and 0.172mm wide. Has anyone ever seen something like this?

image_zps9hqfbg3h.jpg

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  • 4 weeks later...

Id need a longer strip to be sure but it kinda looks like a mix between 2 rhythms: second degree type 1 and a atrial tachycardia with a block. I cant say 3rd degree because it looks like some of the Ps are actually conducting the QRS. I wouldnt doubt that this Pt is going to go into a fib or a flutter at some point soon. I actually have a good strip of an atrial tach w/ a block. i will try and dig it out later. 

As far as treatment, I would treat symptomatically. 

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