If it’s REGULARLY irregular, it’s not atrial fibrillation!
If it’s REGULARLY irregular, it’s not atrial fibrillation!
Episode 64
November 19, 2012

Both physicians and ECG machines tend to over-call atrial fibrillation. This leads to patients being anticoagulated inappropriately and can cause bad outcomes!

If the rhythm is REGULARLY irregular, it’s not atrial fibrillation!

Two important causes of grouped or “clumped” beats
  1. Premature contractions - cause pauses after clumped conduction
    • Clumps of 2 ? Think atrial bigeminy
    • Clumps of 3 ? Think atrial trigeminy
  2. 2nd Degree AV Blocks
    • Mobitz I - Progressive PR lengthening then a dropped beat.
    • Mobitz II​
Always consider hyperkalemia with bizarre rhythms 
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