by Mark Pollet, MD, and Mohammad Saeed, MD
A 56-year-old man with a history of atypical atrial flutter related to atrial septal defect repair presented at the emergency department with palpitations and light-headedness. An electrocardiogram (ECG) was performed (Fig. 1). He had undergone an ablation procedure and therapy with metoprolol and flecainide. He had a history of cardiac arrest and had received a Teligen® model E110 dual-chamber implantable cardioverter-defibrillator (ICD) (Boston Scientific Corporation; Natick, Mass). The ICD was programmed in DDD mode, with a lower rate limit of 60 beats/min and an upper limit of 120 beats/min. Ventricular tachycardia therapy was set to begin at 210 beats/min, and ventricular fibrillation therapy at >230 beats/min.
The Focus on ECGs section, published in the Texas Heart Institute Journal, presents a challenging ECG, a quiz, and a short comment on the interpretation of the ECG. This blog provides a collaborative opportunity to discuss each case in an effort to share the knowledge and the art of interpreting ECGs. Each discussion will close 2 weeks after publication.
