Which telemetry pattern distinguishes atrial fibrillation?

Which telemetry pattern distinguishes atrial fibrillation?

• A. Irregularly irregular rhythm with absent discrete P waves, irregular R-R intervals, and often variable ventricular response.
• B. Regular rhythm with normal P waves before each QRS.
• C. Sawtooth flutter waves best seen in II, III, aVF, with no discrete P waves before QRS.
• D. Narrow complex tachycardia at 150-250 bpm with visible P waves before QRS.

Answer: (A)

Atrial fibrillation shows an irregularly irregular rhythm with no distinct P waves and a variable ventricular (R-R) response. In AF, atrial activity is chaotic, so there are fibrillatory waves rather than organized P waves, and the AV node conducts impulses to the ventricles in an unpredictable, uneven way. That combination—no discrete P waves and highly variable R-R intervals—is what telemetry uses to identify AF. In contrast, a regular rhythm with normal P waves precedes each QRS, the sawtooth pattern of flutter waves indicates atrial flutter, and a narrow complex tachycardia with visible P waves before QRS suggests a supraventricular tachycardia with a more regular atrial activity.

Atrial fibrillation shows an irregularly irregular rhythm with no distinct P waves and a variable ventricular (R-R) response. In AF, atrial activity is chaotic, so there are fibrillatory waves rather than organized P waves, and the AV node conducts impulses to the ventricles in an unpredictable, uneven way. That combination—no discrete P waves and highly variable R-R intervals—is what telemetry uses to identify AF. In contrast, a regular rhythm with normal P waves precedes each QRS, the sawtooth pattern of flutter waves indicates atrial flutter, and a narrow complex tachycardia with visible P waves before QRS suggests a supraventricular tachycardia with a more regular atrial activity.