Be careful here. This may look superficially like sinus but if you look in V1, you can see P waves just before the QRS (there is right bundle branch block (RBBB) and also P waves in the T wave (halfway in between) which are partly hidden. Atrial rate is about 150, ventricular rate 75. This is an atrial tachycardia with 2:1 block (paroxysmal atrial tachycardia or "PAT with block" if it occurs paroxysmally) which may be due to digoxin toxicity, atrial disease, etc. If you got this right, PAT yourself on back; if you choked on it, a more forceful interscapular blow may be indicated. (Note that "PAT" is often a misnomer since the tachycardia may be sustained. So the term "atrial tachycardia with block" is most accurate here.)
2December 13, 2020 9K 11
