<prompt> A 70-year old hypeensive patient with a complaint of palpitations and pre-syncope. On examination, his hea rate is 72 BPM and BP was 150100. ECG performed shows?Atrial flutterAtrial fibrillationMultifocal atrial tachycardiaPSVT  <response>: ECG in lead II and other inferior leads shows the presence of flutter waves Saw tooth pattern. 3-4 flutter waves before every narrow QRS complex. Since the ventricular rate is 75 bpm RR interval, atrial rate shall be obtained by multiplying the ventricular rate by 4 which is 300 bpm The presence of risk factor of hypeension also give clue to diagnosis of atrial flutter. 