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[[Image:Puzzle_2005_2_67_fig1.jpg|Figure 1|thumb]] of a laterally displaced ictus cordis. His 12-lead ECG, shown in figure 1, was in sinus rhythm with some extrasystoles. The electrical axis is vertic

'''ECG 1:'''<br/> A. Type 1 second degree AV block

...in shortness of breath. The electrocardiogram is remarkable as it shows 1:1 retrograde conduction from the ventricle to the atrium, which is best seen

...E000316.jpg|thumb|600px|left|ECG 41 - Gedil. CMP + LBTB + Tekenen van LVH (1 - AVL - V4 tm V6)]]

[[File:E000589.jpg|thumb|600px|left|ECG 1 - A 64 year old woman with atrial fibrillation and left ventricular hypertr

{| class="wikitable" border="1" width="610px" | [[Image:aflutt_small.svg|200px|Atrial flutter - sawtooth in lead II with 2:1 block]]

[[File:ICBA00001.jpg|600px|thumb|left| Sinus bradycardia, Second degree 2:1 AV block with LBBB in the conducted beats and junctional escape beats with

[[File:DVA2393.jpg|Case 1|600px]]

...width="100%" style="border:1px solid #E2ACB1;border-spacing:8px;" border="1" |1 year to 5 years

[[File:E24.jpg|thumb|600px|left|The rhythm is atrial flutter 4:1 block with and atrial rate of about 270 and a ventricular rate of 68/min.]]

[[File:E000764.jpg|thumb|600px|left|The rhythm is atrial flutter 4:1 block with and atrial rate of about 270 and a ventricular rate of 68/min.]]

[[File:E000765_65.jpg|thumb|600px|left|The rhythm is atrial flutter 4:1 block with and atrial rate of about 270 and a ventricular rate of 68/min.]]

{{ImageC |image=ami0001.jpg |link=MI 1|text=[[MI 1]]}} {{ImageC |image=Casus2_2.jpg |link=Case 1|text=[[Case 1]]}}

...phology. The axis is unusual though as it is to the right (large S in lead 1). The R to S ratio in lead V6 is less than one and this favours the diagnos ...ate of this patient's flutter and hence the AV node was able to create a 2:1 block (see EKG below, note SVT in lead V1) and slow down the ventricular ra

|nextname= ICBA case 1 *[[ICBA1|ICBA case 1: Fusion beats]]

[[Image:Puzzle_2005_6_244_fig1.jpg|Figure 1|thumb]] enough, which he did (figure 1).

A wide QRS tachycardia is VT until proven otherwise (1). Features suggesting VT include:- 1) Griffith MJ, Garrat CJ, Mounsey P, Camm AJ. Ventricular tachycardia as the

...R in V1. This VT is some what unusual as the R to S ratio is greater than 1 in lead V6.

[[File:E000382.jpg|thumb|600px|left|Endocarditis 1]]

[[File:E000378.jpg|thumb|600px|left|ECG 1]]