1. ID 383 – 76 year old woman in her family doctor’s office

2. ID 383 – 76 year old woman in her family doctor’s office Can you see P waves?

3. ID 383 – Atrial fibrillation with controlled ventricular rate (66/min) There are no P waves. There are fibrillatory waves that vary in size and shape. The ventricular rhythm is irregularly irregular (atrial fibrillation) – The rate is 66/min

4. ID 383 – Atrial fibrillation with controlled ventricular rate (66/min) Let’s now look at the QRS complexes: There is normal QRS axis (between 0 and 90 degrees)

5. ID 383 – Atrial fibrillation with controlled ventricular rate (66/min) The QRS duration is normal : There is no right bundle branch block, left bundle branch block or non‐specific block

6. ID 383 – Atrial fibrillation with controlled ventricular rate (66/min) There is no right ventricular hypertrophy or left ventricular hypertrophy

7. ID 383 – Atrial fibrillation with controlled ventricular rate (66/min) There are no QRS signs of myocardial infarction –There are normal ST segment and normal T waves

8. ID 383 Final Diagnosis: Atrial fibrillation with controlled ventricular rate (66/min) No other abnormalities There are no QRS signs of myocardial infarction –There are normal ST segment and normal T waves