20-year old patient with sudden onset of palpitations. What does the rhythm strip demonstrate?
Describe and interpret this ECG
ECG ANSWER and INTERPRETATION
Top rhythm strip
- Regular narrow complex tachycardia.
- Pseudo-R’ waves (retrograde P waves) are seen deforming the J point.
Middle rhythm strip
- 12mg adenosine given
- A salvo of broad and bizarre-looking complexes interrupts the rhythm (this is a common phenomenon during chemical cardioversion with adenosine)
Bottom rhythm strip
- The patient has reverted to sinus rhythm.
- The pseudo-R’ waves have now disappeared.
- There are no obvious delta waves of WPW, but this should be confirmed on a 12-lead ECG.
The 12-lead ECG confirms reversion to sinus rhythm and does not demonstrate any features of WPW. The diagnosis is AV-nodal reentry tachycardia (AVNRT).