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Recognition of supraventricular arrhythmias and differention between supraventricular and ventricular rhythm abnormalities in ECG can sometimes be difficult due to indiscernible P wave. 1D echocardiography of tricuspid annular motion can quickly and reliably detect atrial contraction (Picture 1, figure 1a.) which has a characteristic appearance for majority of supraventricular arrhythmias. Since subcostal approach is almost always reliable, it allows simple and rapid recognition and differentiation between supraventricular arrhythmias, e.g. atrial fibrillation (Picture 1, figure 1b.) from atrial flutter and nodal rhythm. Detection of atrial contractions enables recognition of AV dissociation in ECG, which helps in differentiation between supraventricular and ventricular arrhythmias. This technique is also useful in checking the function and mechanical efficiency of atrial pacing. Figure 1a. Atrial contraction / sinus rhythm RA = right atrium A = atrial contraction Figure 1b. Atrial fibrillation RA = right atrium a = fibrillary contractions Abstract P968 Figure. Picture 1

P968 Subcostal M-mode echocardiography of tricuspid annular motion helps recogntion of heart arrhythmias