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