JUDDER BAR FLUTTER

On rounds one day I was presented a case of a elderly gentlemen with chest pain who had a episode of a life threatening heart rhythm disturbance “VFIB/VTACH" while being transported by the Ambulance Service to the Hospital. The Paramedic’s notes said the patients vital signs were stable with a BP of 136/74. The notes also said he looked remarkably well during this rhythm disturbance. At the bedside the patient told us they had taken a especially rough and bumpy road to the hospital. Looking at the rhythm strip I notice normal sinus rhythm followed by wide undulating complexes that return to sinus rhythm. The Heart tracing spikes or QRS complexes marched out unchanged so I concluded that this was artifact caused by the ambulance going over a rough patch of road or a speed bump. Speed bumps in New Zealand are called judder bars. So I explained the house staff that this was judder bar artifact. One of my colleagues suggested I write this up and call it "Judder Bar Flutter". So this is the world premiere of a new rhythm first described by Stephen Stowers MD FACC Senior Consultant in Cardiology Palmerston North Hospital. Cheers from Palmy on the North Island of New Zealand!