Atrial flutter

Atrial flutter

It is a condition in which a rapid atrial rate of around 300/min is associated with 2:1, 3:1 or 4:1 AV block.

Most often, every second flutter beats conduct, giving a ventricular rate of 150 beats per minute. Occasionally

every beat conducts, producing a heart rate of 300 beats per minute.

ECG

Saw-toothed like atrial flutter waves.

Causes

Ischemic heart disease

Rheumatic heart disease

Thyrotoxicosis

Cardiomyopathy

Wolff-Parkinson- White syndrome

Pneumonia

Pericarditis

Pulmonary embolus

Acute and chronic alcohol abuse.

Clinical features

Palpitations

Dizziness

SOB

Chest pain

Syncope

Investigations

Bloods (FBE, TSH, Urea and electrolytes, magnesium, calcium)

ECG- Saw tooth appearance, tachycardia

Management

Rate control with beta-blockers, bisoprolol, etc. May need IV therapy

If hemodynamically unstable then cardioversion

Catheter ablation

Atrial flutter with 2 : 1 Block

Atrial flutter with 2 : 1   to  4 : 1 Block

Atrial flutter with 4:1 Block