Arrhythmias - Atrial Flutter

Question 1

What is Atrial Flutter?

Answer 1

A form of supra ventricular tachycardia characterised by a succession of rapid atrial depolarisation waves.

Question 2

Pathophysiology of Atrial Flutter.

Answer 2

‘Re-entrant rhythm’ in either atrium : electrical signal re-circulates in a self-perpetuating loop due to an extra eletrical pathway without interruption.

Question 3

Rate of Atrial and Ventricular Contraction in Atrial Flutter (2).

Answer 3

1. Atrial Contraction = 300BPM.
2. Only enters ventricles every 2nd/3rd/4th/5th lap due to long refractory period of AV Node = 150/100/75/60BPM Ventricular Contraction.

Question 4

ECG Appearance of Atrial Flutter (3).

Answer 4

1. Sawtooth Appearance = P wave after P wave.
2. Regular Rhythm.
3. Narrow QRS Complexes.

Question 5

Associated Conditions of Atrial Flutter (4).

Answer 5

1. Similar to AF.
2. More Likely with Pulmonary Disease e.g. COPD, OSA, PE, PHTN.

Question 6

Management of Atrial Flutter (4).

Answer 6

Similar to AF :
1. Rate/Rhythm Control.
2. Treat Underlying Cause.
3. Radiofrequency Ablation.
4. Anticoagulation.

Question 7

Which method is curative for most patients?

Answer 7

Radiofrequency ablation of the tricuspid valve isthmus.