Bradydysrhythmias: a differential for too many P waves and a lesson in how to break down difficult rhythms

ECG Weekly Workout with Dr. Amal Mattu


An 81-year-old female presents to the ED with lightheadedness and “funny heart beats”. She has no associated dyspnea and is noted to have normal vital signs. The following ECG is obtained:

Before watching this week’s video, ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. What is the rhythm?
  3. What is the most likely cause of this patient’s ECG abnormalities?