This is a big difference in how you tell if the rhythm is a-flutter or a-fib. No p-waves will be present BUT a wave of f-wave called SAW-TOOTH WAVES.In atrial flutter, you will always have the following: PR interval is not measurable because you don’t have p-waves and the QRS complex is usually less than 0.12 seconds.On the heart monitor you would see a fluctuating heart rate of 110-200 when the a-fib is not controlled. Typically there are 6-10 r-waves in a-fib in 6 seconds, BUT if the patient is having what is called a-fib with RVR (rapid ventricular response) you can have many r-waves varying from 11-200.R-waves will be irregular because of the random fibrillary waves quivering at various times.P-waves are not present so you can’t measure if the p-waves are regular.Therefore, you cannot count the atrial rate. The little humps you are seeing are called f-waves (fibrillary waves). In atrial fibrillation, you will always have the following: And QRS complex will measure less than 0.12 seconds. PR interval will be measurable and be a length of 0.12-0.20 seconds.There will be 6-10 QRS complexes in 6 seconds to equal a ventricular rate of 60-100 bpms.P-waves will be present with atrial rate of 60-100 bpms (meaning there will be 6-10 p-waves present in 6 seconds). In Normal Sinus Rhythm (NSR), you will always have the following: But first, let’s look at a normal rhythm. Now, let’s talk about the difference between the two rhythms.
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