6 doctors weighed in:

Atrial flutter on an EKG does not have a p wave, so how does one calculate the atrial rate?

6 doctors weighed in
Dr. Irv Loh
Internal Medicine - Cardiology
2 doctors agree

In brief: Actually, it does

The p wave reflects activation of the atria (upper chambers), but in atrial flutter, the atria activity is reflected in a "sawtooth" pattern ripping along at about 300 beats per minute, which also represents the atrial activation but from another source and conduction pattern.
The important clinical item is the ventricular rate, dependent on the av node which is the controlling "relay station".

In brief: Actually, it does

The p wave reflects activation of the atria (upper chambers), but in atrial flutter, the atria activity is reflected in a "sawtooth" pattern ripping along at about 300 beats per minute, which also represents the atrial activation but from another source and conduction pattern.
The important clinical item is the ventricular rate, dependent on the av node which is the controlling "relay station".
Dr. Irv Loh
Dr. Irv Loh
Dr. Liviu Klein
Internal Medicine - Cardiology
1 doctor agrees

In brief: F waves

While you are correct that atrial flutter does not have a 'p' wave on ecg, there are 'f' (flutter) waves on the ecg.
Counting the milliseconds between two consecutive 'f' waves gives you the atrial rate.

In brief: F waves

While you are correct that atrial flutter does not have a 'p' wave on ecg, there are 'f' (flutter) waves on the ecg.
Counting the milliseconds between two consecutive 'f' waves gives you the atrial rate.
Dr. Liviu Klein
Dr. Liviu Klein
1 comment
Dr. Jason Rubenstein
To get rate (in beats per minutes) from the milliseconds between F waves, you have to divide it into 60k. Example: 500ms between F waves: 60000/500 = 120 BPM.
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