Which pattern on ECG is associated with Atrial Flutter?

• A. Irregular rhythm with no P waves
• B. Classic "Saw tooth pattern" with flutter waves
• C. Wide QRS complexes
• D. P waves preceding each QRS with regular rhythm

Answer: (B)

Atrial flutter creates a rapid, organized atrial rhythm that produces distinctive flutter waves, giving a sawtooth appearance on the ECG. These flutter waves reflect the consistent, reentrant atrial activity and are often best seen in leads II, III, aVF, and V1. The atrial rate is typically about 250–350 beats per minute, and the ventricular rate depends on how many atrial impulses are conducted through the AV node (commonly resulting in a regular rhythm with patterns like 2:1 conduction). This sawtooth pattern is the hallmark that sets atrial flutter apart from other rhythms.

What would not fit as well: an irregular rhythm with no distinct P waves suggests atrial fibrillation; wide QRS complexes could indicate a conduction problem or other arrhythmias; P waves preceding each QRS with a regular rhythm points to normal sinus rhythm. The sawtooth flutter waves specifically point to atrial flutter.