Peer Reviewed
ECG education

Is this atrial fibrillation?

Vivienne Miller
Abstract
An ECG showing irregularly contracting atria suggests atrial fibrillation.
Key Points
  • Atrial fibrillation is the most common type of tachyarrhythmia and atrial flutter with a 2:1 block is the next most common.
  • The atria contract irregularly in patients with atrial fibrillation and so the RR interval is variable, the P-waves are absent and the baseline undulates.
  • Atrial flutter is usually suspected when the patient’s heart rate is rapid (most commonly 150 beats per minute) and regular, with the characteristic sawtooth waves as described.
  • A 1:1 AV conduction block is uncommon and may result in severe haemodynamic instability and collapse due to heart rates up to 300 beats per minute. It may precipitate ventricular fibrillation.
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