A patient taking an ECG shows a regular sawtooth pattern with 30 P waves within a 6-sec inter-val (30 large boxes). What course of treatment should this patient receive for this arrhythmia?
1. Calcium channel blockers
2. Digoxin
3. Cardioversion
4. Defibrillation
a. 1, 2, and 3 only
b. 2 and 4 only
c. 3 only
d. 1, 2, 3, and 4
ANS: A
First the patient's heart atrial heart rate must be calculated: 30 P waves ? 10 = 300 beats/min. Looking at the patient's atrial heart rate and the sawtooth pattern displayed on the ECG, the pa-tient is demonstrating atrial flutter. Treatment for atrial flutter is to provide medication (digoxin, beta blockers, or calcium channel blockers), allow the arrhythmia to significantly slow down, and then cardioversion is recommended.
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