Ventricular flutter

A rapid ventricular tachycardia, with rates usually over 240 beats per minute, is characteristic of ventricular flutter, with predominantly monomorphic QRS complexes, and an absence of atrial activity (P waves).

The normal P wave in sinus rhythm is slightly notched since activation of the right atrium precedes that of the left atrium. The P wave is upright in a positive direction in leads I and II. A P wave with a uniform morphology precedes each QRS complex. The rate is between 60 and 100 beats per minute and the cycle length is uniform between sequential P waves and QRS complexes. In addition, the P wave morphology and PR intervals are identical from beat to beat.