McGill Case 201

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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.

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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.