AT Will Look Like ST

Vignette: A 60 yo with h/o HTN, HLD, hyperthyroidism is admitted for sepsis. 

Cardiac telemetry showed event of tachycardia (~130 bpm).

Image 1

This will look like sinus tachycardia (ST). However, carrefull examination of initiation and termination would argue against ST. In ST thre is a gradual warm-up and cool-down in rate. In here there is "abrupt" or sudden increase and decrease in rate. Thus, this is paroxysmal atrial tachycardia (PAT)

Image 2

It is even better viewed by a heart rate histogram or trend.

Image 3