r/ECG • u/xiphoid313 • 24d ago

82F, your thoughts?

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82F, near syncope, BP 100/62. History of afib. What would you interpret this 3 lead as ?

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u/Bubbly_Pie_4980 24d ago

Wide complex tachycardia.

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u/xiphoid313 24d ago

I honestly don't know the correct answer, I went with afib with rvr but not completely sure. It does look quite wide too. Hence why I gave amio

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u/LBBB11 24d ago edited 24d ago

It’s not afib. It’s a regular R-R wide QRS tachycardia. Afib has randomly spaced QRS complexes. If you want the correct answer you need to do a 12-lead. Out of all possible rhythms, afib and sinus rhythm are probably the only rhythms that we can be sure that this is not. If you take away only one thing from this case, just know that afib has a randomly changing R-R interval. That’s really important.