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Answer To The ECG Graph |
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P Waves are clearly seen in lead V1 preceding each QRS complex during the tachycardia @ 170 bpm. These P waves are upright in the inferior leads, best noted in the last complex before tachycardia termination. Thus the diagnosis of atrial tachycardia is clear. The QRS alternans seen in the inferior leads is unusual for atrial tachycardia at rate < 200 bpm. The overall P waves during tachycardia are somewhat similar to sinus P waves. This suggests the tachycardia focus to be high in the right atrium, not far from the sinus node. The tachycardia was successfully ablated around the crista terminalis. After this the left ventricular function returned to normal. |
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