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Cardiology > Atrial Flutter > Flashcards

Atrial Flutter Flashcards

1
Q

What is atrial flutter a form of?

A

Supraventricular tachycardia

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2
Q

What is atrial flutter characterised by?

A

A succession of rapid atrial depolarisation waves

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3
Q

What is atrial flutter caused by?

A

a “re-entrant rhythm” in either atrium- the electrical signal re-circulates in a self-perpetuating loop

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4
Q

What is a re-re-entrant rhythm?

A

The electrical signal re-circulates in a self-perpetuating loop

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5
Q

What is the re-entrant rhythm due to?

A

An extra electrical pathway.

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6
Q

At what speed does the re-entrant rhythm stimulate atrial contractures?

A

300 bpm

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7
Q

How often does the signal make its way into the ventricles?

A

Every second lap due to the long refractory period to the AV node

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8
Q

At what speed does the re-entrant rhythm stimulate ventricular contractures?

A

150 bpm

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9
Q

What conditions are associated with Atrial Flutter?

A
  • Hypertension
  • Ischaemic heart disease
  • Cardiomyopathy
  • Thyrotoxicosis
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10
Q

What would you see on an ECG of someone with atrial flutter?

A

‘sawtooth’ appearance

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11
Q

What does sawtooth appearance on an ECG mean?

A

P wave after P wave.

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12
Q

What is the medical management of Atrial Flutter?

A

Rate/rhythm control with beta blockers
Cardioversion

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13
Q

What is the curative management for most patients?

A

Radiofrequency ablation of the tricuspid valve isthmus

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14
Q

Which atrium is mainly affected by atrial flutter?

A

Right atrium

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15
Q

What is atrial flutter likely to be caused by?

A

Pulmonary disease

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16
Q

What pulmonary diseases is atrial flutter associated with?

A

COPD
Obstructive sleep apnoea
Pulmonary emboli
Pulmonary hypertension

17
Q

Why are these impulses not transmitted as fast to the ventricles?

A

AV node has a relatively long refractory period and is not able to conduct impulses down the His-Purkinje system at such a fast rate.

18
Q

What is the management of atrial flutter in a patient who is haemodynamically unstable?

A

Direct current synchronised cardioversion

19
Q

What might indicate that a patient is haemodynamically unstable?

A

Shock ( end organ hypoperfusion)
Syncope (evidence of brain hypoperfusion)
Chest pain (evidence of myocardial ischaemia)
Pulmonary oedema (evidence of heart failure)

20
Q

How can atrial flutter be managed if a patient is haemodynamically stable?

A

Same as AF:
Rate control via BB and CCB

21
Q

What would you consider if the patient’s atrial flutter isn’t controlled with BB or CCB?

A

Cardioversion

Cardiology (66 decks)

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