Electrocardiographic and electrophysiologic features of type ii atrial flutter morton f arnsdorf, md dec 30, 1998 type i and type ii atrial flutter were differentiated by wells et al in 1979 [1]. buy generic viagra online Type i (or common atrial flutter) was separated from type ii on the basis of rate, the existence of an excitable gap, the ability to transiently entrain type i but not type ii, and the observation that type ii could change in a "stepwise" manner to type i. buy viagra canada (see "electrocardiographic and electrophysiologic features of type i atrial flutter"). buy cheap viagra Electrocardiogram in type ii atrial flutter ¡ª the electrocardiographic features of type ii atrial flutter with normal av nodal conduction are (show ecg 1) [1]:   •  p waves are absent.   •  biphasic flutter waves (f waves) are present at a rate of that is faster than that observed in type i atrial flutter, ranging from 340 to 440 beats/min.   •  the f waves usually do not have an isoelectric interval between them. viagra on women effects   •  although type i may be morphologically indistinguishable from type ii, there often is more apparent positivity in the f waves recorded in the inferior leads. generic viagra   •  the f waves are regular and have a rather constant amplitude, duration, morphology, and reproducibility throughout the cardiac cycles. This uniformity distinguishes type ii atrial flutter from coarse atrial fibrillation. soft viagra under tongue   •  there is usually 2:1 av nodal conduction in both type ii and type i atrial flutter in the absence of av nodal disease or drugs that slow av nodal conduction. viagra on women effects Thus, the ventricular rate is generally about cardinal beats/min. Even ratios of input to output (eg, 2:1, 4:1) are much more common than odd numbers (eg, 3:1, 5:1). viagra on women effects Odd ratios of conduction may be more common than in type i atrial flutter, at least at rapid atrial rates, since there is more opportunity in type ii flutter for partial penetration of and concealed conduction in the av node. Odd numbered responses may indicate bilevel block in the av node. generic viagra without prescription   •  the qrs complex is narrow unless there is functional aberration, preexisting bundle branch or fascicular block, or preexcitation. The determinants of the ventricular re. viagra coupon viagra free sample no prescription
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