This case report is kindly provided by Michael Rosengarten from McGill and is part of the McGill Cases. These cases come from the McGill EKG World Encyclopedia.
The rhythm is atrial flutter with flutter waves seen best in the inferior leads and in leads V1 to V3. The atrial rate is about 250/min. The QRS is wide (>120ms) an there is a tall R' wave in V1 and a shallow S in V6. The axis of the QRS seems normal. The EKG shows a right bundle branch block.
