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Cas du mois Janvier 2020 - Rythmologie-

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Atrial tachycardia with Wenckebach atrioventricular conduction

64 year old patient, diabetic, having a sleep apnea syndrome with poor compliance, consults the emergency for palpitations. Physical examination shows a precarious hemodynamic state. Twelve-lead ECG showed a supraventricular tachycardia. (Figure 1)

Because of the hemodynamic instability, we opted for an electrical cardioversion. The ECG after the external electric shock is attached. (Figure 2)

What is your interpretation for the second strip :