Atrial Flutter

Question 1

Define

Answer 1

Atrial tachycardia with atrial rates usually above 250 pbm - 320 bpm

Question 2

Epidemiology

Answer 2

much less common than AF Prevalence ↑ with age, more common in MEN

Question 3

Symptoms

Answer 3

palpitations, irregular rate fatigue, dyspnoea, CP, syncope, ±thromboembolism

Question 4

Signs

Answer 4

rapid plus e(may be irregular), atrial flutter waves in jugular venous pulse, ±HF, respiratory distress, hypotension

Question 5

Investigations

Answer 5

ECG shows absent P waves, irregular QRS complexes
Uneven baseline (fibrillations)
Bloods → cardiac enzymes, TFT, lipid profile, U&Es, Mg2+, Ca2+
Echocardiogram → to assess for mitral valve disease, LA dilatation, LV dysfunction or structural abnormalities

Question 6

Management

Answer 6

1. beta blocker/ ca channel blocker/ amiodarone
2. anticoagulation
3. cardioversion

failure of 3 - ablation