This rhythm strip shows atrial tachycardia. The characteristic features demonstrated here include: a rapid, regular 
 atrial rate  between 180 and 240 beats per minute; and a constant 
 P-R interval for those beats that are conducted. In this case, there is  2:1 a-v block with an atrial rate of 180 and the ventricle responding to every other P wave at a rate of 90. Atrial tachycardia with block is frequently due to digitalis intoxication.