#TYPICAL ATRIAL FLUTTER AND ECG HOW TO#

For example, in atrial flutter with an atrial rate of 280, and a ventricular rate, or pulse rate, stuck at 70, it is referred to as 4:1 A-V conduction.Ītrial flutter usually indicates underlying disease and may show symptoms of palpitations, shortness of breath, anxiety, or weakness.Ītrial Flutter Electrical impulses circulate around the tricuspid valveįlutter (F) waves have a sawtooth appearanceĪV node slows down rapid atrial contractions The number of F waves to QRS complexes is expressed as a ratio. The ventricles often respond to the impulses at a regular rate, therefore the QRS complexes are usually normal and regular. With such rapid atrial contractions, the AV node slows them down, often with every second or third contraction reaching the ventricle. These atrial contractions produce flutter (F) waves that have a sawtooth appearance. The atria discharge between 240 to 400 regular impulses every minute. We also want to ask, what is the width of the QRS complex? This represents the contraction of the ventricles (normally 0.06-0.12 sec/1.5-3 small squares) & the QRS complex is within the normal range here.Ītrial flutter occurs when the electrical impulses of the heart take an abnormal path through the atria, usually circulating around the tricuspid valve in the right atrium.

In this normal sinus rhythm, the PR interval does fall in the normal range.

How long is the PR interval? (normally 0.12-0.20 sec./3-5 small squares) – represents the time it takes an impulse to travel from the sinus node to the ventricles. There might be a slight variation in length and that is okay, we have to allow for some fluctuation in heart rate.ĥ. Are the R waves regular? Do this again for the R waves & they also measure out equal or almost equal distances apart. In this case, the P waves do measure out to be regular distances apart.Ĥ. Are the P waves regular? Start from the beginning of one P wave to the beginning of the next P wave, measuring with calipers or a paper. Are there P waves present? Since we have 3 seconds here, we’ll multiply the number of P waves by 20, so 4 P waves times 20 shows an atrial rate of 80 bpmģ. Here we have 4 R waves in 3 seconds, times 20, equals 80 bpm (remember normal HR falls between 60-100).Ģ. What is the heart rate? Count how many R waves in 6 seconds & multiply by 10, or count how many in 3 seconds & multiply by 20. Let’s evaluate a normal sinus rhythm using these 5 steps:ġ. How long is the PR interval? (Normally 0.12-0.20 sec./3-5 small squares) & what is the width of the QRS complex? (normally 0.06-0.12 sec/1.5-3 boxes). Are the R waves regular? Again, measure with calipers or a paper.ĥ. Are the P waves regular? Measure with calipers or a paper.Ĥ. (this is the atrial heart rate – remember the P wave represents the atria contracting).ģ. Are there P waves present? Count how many in 6 sec. What is the heart rate? Count how many R waves in 6 seconds (this is the ventricular heart rate – the QRS complex represents the ventricles contracting).Ģ.

#TYPICAL ATRIAL FLUTTER AND ECG HOW TO#

If you haven’t already, you may want to watch our video on basic EKG interpretation first – it goes into more detailed steps of how to read an EKG strip and is a good refresher.įirst we’ll go over a simplified 5-step approach to interpreting all EKG strips:ġ. In this video we’ll be looking at how to interpret an EKG strip, specifically atrial flutter and atrial fibrillation.

Typical atrial flutter and ecg