Sinus Rhythm with Atrial Tachycardia

Sinus rhythm with atrial tachycardia and one atrial extrasystole

ECG Interpretation

  • The first beat has a normal P wave and is normal (i.e. a sinus beat)
  • The next four beats, at about 100/min, have abnormal (inverted) P waves, and this is an atrial tachycardia
  • After a pause the next two beats have normal P waves and are in sinus rhythm at about 43/min
  • After two sinus beats there is an extrasystole with an inverted P wave; this is an atrial extrasystole (PAC)
  • Normal axis
  • The QRS complexes, ST segments and T waves are normal

Clinical Interpretation

Since the patient had her symptoms at the time of the recording, we can be confident that the ECG findings explain them. Atrial extrasystoles are not a manifestation of cardiac disease, but the atrial tachycardia may be and will need treating on symptomatic grounds.

What to do ?

Ensure that there is no other evidence of heart disease. She should stop smoking and avoid alcohol, coffee and tea. A beta-blocker will probably prevent the tachycardia.