Image Question-16

What is the diagnosis of ECG?


What is the diagnosis of the ECG?


A. Sinus Tachycardia

B. Atrial Fibrillation

C. AVNRT

D, AVRT



Which of the following is a typical AVNRT?

A. Slow-Fast AVNRT

B. Fast- Slow AVNRT

C. Slow-Slow AVNRT

D. Fast-Fast AVNRT



Types of AVNRT –


A. “Typical”, “common”, or “slow-fast” AVNRT


Slow AV nodal pathway- anterograde limb of the circuit -conduct towards the ventricle

Fast AV nodal pathway – the retrograde limb – conduct to the atria


B. “Atypical”, “uncommon”, or “fast-slow” AVNRT


Fast AV nodal pathway – anterograde limb

Slow AV nodal pathway- retrograde limb .


C. “slow-slow” AVNRT –

Atypical AVNRT

Slow AV nodal pathway – the anterograde limb

Left atrial fibres that approach the AV node from the left side of the inter-atrial septum – retrograde limb


Typical AVNRT


“slow-fast” AVNRT

Anterograde conduction – via the slow pathway

Retrograde conduction -via the fast pathway



ECG may show typical changes that confirm the diagnosis-


  • QRS duration <120 ms, unless a heart block is suspected
  • Inverted P wave- occurs very soon after QRS complex.
  • RP interval is short – less than 50% of the time between consecutive QRS complexes.
  • RP interval is often so short that the inverted P waves may be buried within or seen immediately after the QRS complexes, appearing as


“pseudo R prime” wave in lead V1 or

“pseudo S” wave in the inferior leads


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