February 15, 2023

Atrial Flutter with Lead Reversal


Pt came is due to palpitations

ECG case digitized using PMCardioApp

What is the rhythm? 

  1. ST - sinus tachycardia
  2. AVRT - AV reentry tachycardia
  3. AVNRT- AV nodal reentry tachycardia
  4. AT/AFL-atrial tachycardia/flutter

This indeed looked AFL. However it sis weird that I & aVL showed the typical AFL surface ECG that should have been seen in inferior leads (also V2 looked V1). The possible explanation could LA/LL lead reversal as you can see in the diagram. In addition, there must V1 & V2 reversal.

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