How do you detect atrial flutter on ECG?

The most common narrow complex regular tachycardias are sinus tachycardia, atrial flutter, atrial tachycardia that blocks, and paroxysmal supraventricular tachycardia. Carotid sinus massage is useful in differentiation. Irregular narrow-complex tachycardias are usually atrial fibrillation.

The diagnosis of atrial fibrillation is confirmed with a standard 12-lead ECG. P waves are absent, coarse “fibrillatory waves” can frequently be seen and sometimes no atrial activity can be identified. The QRS complexes are “irregularly irregular ”, with varying R-R intervals.

ECG features of atrial flutter