Identify this cardiac rhythm:

Question

BlackTom AI · Accepted Answer

The task asks to identify the cardiac rhythm shown in the ECG strip.
Option 1: Normal sinus rhythm. This would present with regular, upright P waves preceding each QRS complex and a consistent R-R interval. The provided tracing shows more than just a simple, normal P-QRS relationship, and there are distinctive atrial patterns not seen in plain sinus rhythm.
Option 2: Atrial fibrillation. AFib is characterized by an irregularly irregular rhythm with absence of discrete P waves and a chaotic, fibrillatory baseline. The strip here appears more organized with a recognizable repeating pattern rather than the erratic baseline of AFib, making AFib unlikely.
Option 3: Atrial flutter. This rhythm features a sawtooth (flutter) pattern of atrial activity, typically at a rapid rate, with a more regular ventricular response depending on AV conduction (often 2:1 block). The image shows a recurring, organized sawtooth-like waveform in the atrial portion and a regular ventricular cadence, which is classic for atrial flutter.
Option 4: Ventricular tachycardia. VT usually presents as a wide-complex tachycardia with monomorphic QRS complexes and a rate that is fast, often with absent or abnormal atrial activity linkage. The provided strip does not show the wide, fusion/m fusion complexes or the typical VT morphology; instead, it shows organized atrial activity compatible with flutter.
Taken together, the key feature supporting atrial flutter is the repeating, sawtooth atrial pattern with a relatively regular ventricular response, rather than the other patterns described above.

Identify this cardiac rhythm:

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