Atrial Flutter Flashcards
1
Q
Atrial Flutter General
A
- One of the more commons supraventricular arrhythmias
- Most have associated AF
- Guideline for flutter is very similar to AF
2
Q
Atrial Flutter Pathophysiology
A
- Abnormal and rapid heart rhythm, typically a rate of around 300 bpm
- Atrial flutter is macro-reentrant tachycardia can be typical or atypical
- In typical rhythm originates from tricuspid level of right atrium, also called the cavotricuspid isthmus
- In atypical the origin is elsewhere, ECG patterns are variable
3
Q
Atrial Flutter Epidemiology
A
Less common than AF but second most common arrhythmia
- Prevalence increases with age
- More common in men, men are 80% of cases
4
Q
Atrial Flutter Aetiology
A
- Age is most important risk factor
- Structural abnormalities are a strong risk factor
- Atrial dilation strongest predicting factor for development of atrial flutter
- Coronary heart disease
- Atrial dilation due to septal defects, pulmonary emboli, valve dysfunction, ventricular failure
- Hypertension
- Obesity
- Cardiac surgery and ablation procedures…
5
Q
Atrial Flutter Presentation
A
- Can be asymptomatic
- ECG finding
- Syncope
- Heart failure
- Thromboembolism with TIA
- Pulse may be regular or irregular, usually rapid
- Usually conducted at 2:1, 1:1 can occur but is often fatal
6
Q
Atrial Flutter Differentials
A
AF, WPW
7
Q
Atrial Flutter Ix
A
- ECG: sawtooth flutter waves most easily seen in II, III, and aVF, with atrial rates 240-340
- Investigate for associated cause
- Echo to evaluate underlying cardiac function and structure
- Atrial flutter has strong association with structural defects
8
Q
Atrial Flutter Management
A
- If unstable; shock
- If stable; BB and anticoagulant (if indicated)
- If refractory; catheter ablation
- Similar to AF but catheter ablation tends to more effective; suggested first line therapy
- Pharmacological cardioversion if <48hrs, if >48hrs; 3 weeks anticoagulation then electrical
9
Q
Atrial Flutter Complications
A
- Heart failure
- Thromboembolism
