Miscellaneous ECG Quiz 24 Answer

1. Ventricular pacing
2. Atrial fibrillation

At times it is difficult to distinguish atrial fibrillation from atrial flutter on the ECG. This example shows coarse "fibrillatory waves" in the setting of atrial fibrillation. This are of varying morphology unlike those in atrial flutter. This is not quite the typical "sawtooth" pattern for atrial flutter, but it is similar.

Also note the pacing spikes on this ECG are quite large. Older devices that were unipolar appeared like this, however most current pacemakers have quite small pacemaker spikes on the ECG which can even be difficult to detect at times.

Related Topic Reviews: Atrial Fibrillation ECG Review