Bix rule, atrial flutter

 

(P 또는 T파)가 QRS 사이의 절반 위치에 오면 P파가 QRS에 묻혀 있는 atrial flutter 2:1 block을 고려하라

 

(P 또는 T파)라고 표현을 했지만 wide flutter P wave이며 일반적인 T 파보다는 뾰족하다.

 

Harold Bix, a cardiologist from Vienna, noted that if a P-wave is located halfway between two QRS complexes, there’s a good chance there is also a P-wave buried inside the QRS as well. Since flutter waves tend to be somewhat wide and rarely fall perfectly inside a narrow QRS complex, you can often find signs of buried waves as slurring in the upstroke or downstroke of the QRS. In the EKG above there is a slight notch or slur at the tail end of each QRS complex, confirming that there is indeed atrial activity hidden there.