What is this Rhythm?

==================================My Comment by KEN GRAUER, MD (1/26/2023):==================================While reading ECGs — Dr. Smith came across the intriguing tracing shown in Figure-1. No history was available. However, the rhythm is indeed challenging  — and illustrates a number of important principles in rhythm interpretation of interest to all emergency care providers.How would YOU interpret the ECG in Figure-1? Can you come up with a definitive rhythm diagnosis?Figure-1: 12-lead ECG and simultaneously-recorded 3-lead rhythm for today ' s case. (To improve visualization — I ' ve digitized the original ECG using PMcardio).=======================================REVIEW: MY Approach to Rhythm InterpretationAs always — I favor beginning my interpretation of 12-lead ECGs with a look at the cardiac rhythm. Mysystematicapproach to rhythm interpretation entails assessment of the5KEY Parameters, which areeasily recalled by use of the memory aid," Watch yourPs,Qs and 3Rs ". The questions to ask when assessing these 5 Parameters are:Are there P waves (or other sign of atrial activity)?Is the QRS wide?What is the Rate? (looking both at the atrial and ventricular rates IF these are different).Is the rhythm Regular? (and if not — Is the rhythm “irregularly irregular”, as in AFib — or is there a pattern of “regular...

Source: Dr. Smith's ECG Blog - January 26, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs