Atrial Flutter

Question 0

Is there a QRS interval?

Answer 0

Yes: normal limits of <.12

Question 1

In atrial flutter, is there a P wave?

Answer 1

NO P wave

Question 2

Is there a PR interval?

Answer 2

No PR interval

Question 3

Is the rate normal in atrial flutter?

Answer 3

No; Atrial rate is between 220 & 350 bpm

Ventricular rate is < 300

Question 4

Is the Rhythm regular in A. Flutter?

Answer 4

Yes or No

Question 5

What is the major characteristic of A. Flutter?

Answer 5

The P waves have a SAWTOOTHED appearance.

Question 6

What is happening in the heart during A. Flutter?

Answer 6

The SAWTOOTHED picture is caused by electrical “RE-ENTRY” of the AV NODE.
The AV Node cannot respond to so many electrical impulses thus selecting some for entry and blocking others.

Question 7

How do we categories or name Atrial Flutter?

Answer 7

Depends on the number of SAWTOOTHED waves:

1. 2:1
2. 3:1
3. 4:1

Question 8

What are 5 major Predisposing conditions of Atrial Flutter?

Answer 8

1. COPD
2. HTN
3. HF
4. CAD (Coronary Artery Disease)
5. MI

Question 9

What are 5 more predisposing factors of Atrial Flutter?

Answer 9

1. Atrial Flutter can happen independently
2. Heart abnormalities
3. Hyperthyroidism
4. Alcohol
5. Ineffective Atrial Depolarization

Question 10

What are some pharmacological Tx for Atrial Flutter?

Answer 10

1. Digoxin*
2. Metoprolol (BB)
3. Diltiazem (CCB)
4. Anticoagulants
   A. Warfarin/Coumadin
   B. Heparin
   C. Enoxoparin

Question 11

Is Atrial Flutter a Shockable Rhythm?

Answer 11

No; CARDIOVERSION is advisable though!

*Premedicate pt. With Diazepam!