Atrial Flutter With 3:2 AV Conduction-KH
Frank G.Yanowitz, M.D.
This 12-lead ECG shows a subtle bigeminal rhythm resulting from atrial flutter with a 3:2 AV conduction ratio; RR intervals alternate by a small duration. This is uncommon! The impulses from the atrial flutter conduct through the AV junction in a Wenckebach sequence; for every 3 flutter waves the second conducts more slowly than the first, and the third flutter wave is blocked.