Please help me interpret this ECG strip

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Hi I need help with interpreting the rhythm for this ecg strip

http://img22.imageshack.us/img22/9646/ecgq.jpg

I'm thinking that its atrial fibrillation because its irregular and the P waves seem to be replaced with fibrillatory waves. I also noticed ST depression in lead II III and aVF which means ischaemia to the right coronary artery right?

I'm still a nursing student so all this is very new to me.

Atrial fibrillation with rapid response. Positive deflection in I, II, and III suggests normal axis. With such a chaotic baseline, appreciating these ST changes some are talking about is not all that feasible IMHO.

Just as a side note guys, SVT is simply a term to describe a nebulus tachycardia that originates above the ventricles. It can include Afib with RVR, MAT and so on.

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Thank you everyone! Just wondering whether there's any significance in it being fine or coorifice??

I'm searching on the internet and couldn't fine a simple explanation for this.

This one would be a coorifice a-fib right?

Also, how did everyone calculate the artrial rate? I know that its suppose to be 350-600 bmp, but its doing my head in trying to work it out.

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Specializes in ER, ICU.

It is afib, irregularly irregular. There is no ST depression in the inferior leads, what you are seeing is Twave inversion. One cause of Twave inversion is ischemia, which could easily be caused by the rate, depending on the age and health of the patient. The inferior wall is only supplied by the RCA in MOST patients but not all. Some patients get their flow from the Circumflex (30%). There is some ST depression in the lateral leads which could also be ischemia, this is supplied by the circumflex. Your thinking process is good though, keep going!

Chris CEN

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