Normal sinus rhythm on an electrocardiogram.

ECG tracing showing a regular heart rhythm with narrow QRS complexes and consistent P waves.

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- The ECG shows a regular rhythm with narrow QRS complexes.
- There are no visible P waves before each QRS complex.
- The heart rate is approximately 150 beats per minute (calculated by counting R-R intervals).
- This pattern is consistent with atrial flutter with 2:1 AV conduction.
- Atrial flutter is characterized by sawtooth flutter waves, often best seen in leads II, III, and aVF.
- In this case, the flutter waves may be buried in the T waves or baseline due to the 2:1 conduction ratio.
- Management depends on symptoms, hemodynamic stability, and underlying cause.
- Acute management may include rate control with AV nodal blocking agents or cardioversion if unstable.
- Long-term management may involve anticoagulation, rate control, or rhythm control strategies.

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