%0 Journal Article %T Irregular rhythm? %A A. W. G. J. Oomen %A F. F. J. Rozestraten %J Archive of "Netherlands Heart Journal". %D 2019 %R 10.1007/s12471-019-1231-8 %X The electrocardiogram recorded at presentation (Fig. 1 in the Question, 10.1007/s12471-019-1230-9) shows an atypical atrial flutter with a cycle length of approximately 300£żms. There is a remarkable variability of 2:1 to 4:1 conduction of the atrial flutter to the ventricles. This can best be explained by alternating Wenckebach periods %U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6393571/