ATRIAL FLUTTER


DEFINITION

Atrial flutter is characterized by a regular rapid atrial rate of 250-350/min. Where ventricles respond to every second, third or fourth heart beat (2:1,3:1 atrioventricular block).

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atrial flutter

CAUSES

  • Organic heart disease (ischemic, rheumatic, congenital).
  • Pericarditis
  • Acute respiratory failure
  • 1st week following open heart surgery.

ELECTROCARDIOGRAPHIC FEATURE

Characteristic flutter waves are seen as regular saw toothed waves.

MANAGEMENT

  • Immediate conversion to sinus rhythm can be accomplished by direct current cardioversion or atrial pacing.
  • Initial reduction of ventricular rate using digoxin. Beta blockers or verapamil followed by conversion to sinus rhythm using quinidine, amiodarone, disopyramide.
  • Prevention of recurrences can be accomplished by quinidine, amiodarone, disopyramide or flecainide.