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Atrial flutter with variable atrial to ventricular conduction causes irregular ventricular rhythms
Regular atrial activity (F-waves) at a rate of ~240-360 bpm
Ventricular rate is determined by the AV node, when variable, there is a regularly irregular rhythm
Sawtooth pattern is best seen in V1 & lead II
Consider atrial flutter with variable conduction when dealing with narrow complex irregular rhythms
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