Accelerated Nodal Rhythm

This is a recording from a a woman in her 50's with a long standing history of asthma and palpitations, she was on amiodarone at the time of the recording. The patient had just been converted from supraventricular tachycardia. The rhythm is regular, the QRS is narrow, and p waves are not clearly seen, except for a possible one at the beginning of the second QRS in the rhythm strip. This could be a sign of digitalis toxicity but this was not believed to be the case for this patient.