Misdiagnosis of atrial fibrillation occurs more often when atrial activity is prominent on an ECG in more than one lead. In conclusion, atrial fibrillation is frequently misdiagnosed as atrial flutter. The ECG shows regular flutter waves (F-waves not to be confused with f-waves seen in atrial fibrillation) which gives the baseline a saw-tooth appearance. ECG 3 was correctly identified by 91% of cardiology fellows and cardiologists and by 82% of house officers and internists (P =. Biatrial electrograms during coarse atrial fibrillation and flutter-fibrillation. R wave progression in poor in leads V1-V3. ECG 2 was correctly identified by 26% of cardiology fellows and cardiologists and by 37% of house officers and internists (P =. In addition to coarse atrial fibrillation, this ECG also shows lateral ST segment depression and T wave inversion in inferior leads. An EKG conducted upon arrival showed a heart rate of 133 bpm, AFib-Flutter with rapid ventricular response and nonspecific ST abnormality (Fig. The distinction between atrial flutter and atrial. Prolonged recordings will uncover an irregular rate and variation in P wave morphology (as compared to a regular rate and P wave morphology with atrial flutter). Cardiology fellows and cardiologists correctly identified ECG 1 more often than house officers and internists (95% vs 63% P < or =. Coarse atrial fibrillation may mimic atrial flutter over limited electrocardiogram (ECG) strips.
Overall, ECG1 was correctly identified as atrial fibrillation by 79% of physicians, ECG 2 was correctly identified as atrial fibrillation by 31%, and ECG 3 was correctly identified as atrial flutter by 90%. In contrast, atrial flutter and AFib are two of the main types of atrial tachycardia. ECG 1 showed atrial fibrillation with prominent atrial activity (>0.2 mV) in lead V1 ECG 2 displayed atrial fibrillation with prominent atrial activity (>0.2 mV) in leads III and V1 and ECG 3 displayed atrial flutter. A questionnaire containing three 12-lead ECGs was mailed to 689 physicians, with multiple-choice questions asking whether the rhythm on each ECG was atrial flutter or atrial fibrillation. After all, both have to do with your heart rate and both start in the upper.
The purpose of this study was to determine the ability of physicians to differentiate atrial flutter from atrial fibrillation on a surface electrocardiogram (ECG). It’s easy to confuse atrial fibrillation (AFib) with what’s called supraventricular tachycardia (SVT).
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