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ECG Obtained a Peak Dobutamine Infusion

Image 2 of 5 in Series "The Electrocardiographic Diagnosis of Supraventricular Tachycardias"

Description

At peak dobutamine dose (30 mc/kg/min) and following administration of atropine (0.4 mg, IV), a regular narrow QRS complex tachycardia is present. Rate is 154/min. No atrial activity is visible. The differential diagnosis includes sinus tachycardia, atrial tachycardia, AV nodal reentrant tachycardia, AV reentrant tachycardia and atrial flutter.

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This image is part of the series "The Electrocardiographic Diagnosis of Supraventricular Tachycardias"

Other images in this series

Baseline ECG Prior to a Dobutamine Echocardiogram

by: Joe B. Calkins, Jr., M.D.

The rhythm is normal sinus rhythm at a rate of 66/min. Voltage criteria for left ventricular hypertrophy and delayed R wave progression are present.

Demonstration of Sinus Tachycardia following Premature Ventricular Complexes

by: Joe B. Calkins, Jr., M.D.

The regular narrow complex tachycardia at a rate of 154/min persisted approximately for 2 minutes. This ECG was obtained 16 seconds after dobutamine infusion was terminated. Three premature ventricular complexes (PVCs) are present. P waves are seen in the pause following first and second PVC, confirming the presence of sinus tachycardia.

Suspected Atrial Flutter with Variable AV Conduction

by: Joe B. Calkins, Jr., M.D.

ECG from a patient with an irregular narrow QRS complex tachycardia with a sustained rate of approximately 150/min. Atrial flutter was suspected based on the rate and the presence of negative baseline deflections that marched out through the recordings in leads II, III, aVF and V1.

Confirmation of Atrial Flutter with the Administration of Adenosine

by: Joe B. Calkins, Jr., M.D.

The presence of atrial flutter was confirmed with the administration of IV adenosine. This recording was obtained approximately 10 seconds after adenosine, 6 mg, was administered intravenously, which resulted in transient slowing of AV nodal conduction and demonstration of the flutter waves.