A 31-year-old man with known congenital heart disease, for which he underwent surgery as a child, presents to the emergency department with palpitations that developed while he was jogging.
He reports occasional episodes in the past, but they have usually been short-lived. This episode has lasted for 2 hours and as a result he sought medical care. He is noted to have a heart rate of 270 bpm. The rest of his physical examination is unremarkable.
What is the etiology for the tachycardia?
![Read more about the article Atrial Flutter: ECG Interpretation [With Examples]](https://manualofmedicine.com/wp-content/uploads/2022/01/Atrial-Flutter-with-4-1-AV-Block-300x135.png)
