ECG changes in atrial flutter
Last reviewed 01/2018
These include:
- if the P waves are about 300 per minute, and there is a 3:1 block, then the ECG will have a characteristic saw-tooth appearance
- if atrial flutter is associated with a 2:1 block, P waves are difficult to recognise because of the superposition of the preceding T waves
- flutter waves are most clearly seen in V1, II, III & aVF
- an uncertain diagnosis can be confirmed if carotid sinus pressure results in an increase in the uncoupling of the atria and ventricles, revealing the flutter waves
- always consider atrial flutter if a patient has a regular tachycardia of 150