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Can You Guess The Rhythm?

Tue, 10/01/2013 - 21:56 -- Dawn

This video is from Jan Vitek from Prague, Czech Republic, furished to the ECG Guru by his colleague, Jenda Enis Stros, with permission.  It is a clip taken from surgery, OPCAB - Off-pump coronary artery bypass surgery, without extracorporeal circulation.  The patient is a 75-year-old male patient with critical left main coronary artery stenosis.  Can you guess what the dysrhythmia is? 

If you cannot play the video on the device you are using, go to this YouTube LINK.




Submitted by benant2 on

Great video. Although I could not get the video to loop, which would have made it easier to watch, rather than starting and stopping, it looks to me to be atrial flutter with a 3:1 block. One can very clearly vusualise the auricle of the right atrium in the top right of the video, and although hard to count, due to reason above (8 seconds makes it difficult with my eyes), there appear to be 3 atrial contractions for every ventricular contraction.  

The motion and speed of the auricle was beautifully symmetrical and regular, ruling out fibrillation. 

Look forward to hearing what others think.

Submitted by Dawn on

The atria can be observed beating quickly, with a regular rhythm, and the ventricles are beating more slowly, also with a regular rhythm.  Best guess is 2:1 conduction, or possibly 3:1.

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