Rhythm interpretation: when to worry about cardiac rhythm strips

ECG Weekly Workout with Dr. Amal Mattu


A 55-year-old woman with PMHx of CHF presents to an urgent care facility with shortness of breath, orthopnea, and weight gain after running out of her diuretics for the past week. She denies any chest pain and has no other acute complaints. While being observed and treated with diuretics, the cardiac monitor alarms for the following rhythm:

Before watching the video, look closely at this ECG and ask yourself:

    1. What rhythm abnormality do you notice?
    2. How would you treat this rhythm in a hemodynamically stable patient who is otherwise asymptomatic?
    3. How would this rhythm change your recommended disposition?