Atrial Flutter (SVT) Flashcards
What is Atrial flutter
Organised atrial rhythm of 300bpm caused by a macro circuit in the right atrium
What role does the macro circuit play in flutter
It restarts the Conduction loop rapidly at the AV node but due to its long refractory time there is inconsitency in conduction to bundle of His and purkinge fibres and blocked atrial impulses head to the ventricles
What are the causes of flutter
Idiopathic Pulmonary (Most common) -COPD -PE -Pulmonary HTN IHD Sepsis Alcohol Cardiomyopathy
Wat are the symptoms of flutter
Asymptomatic Palpitations Dizzy SOB Chest pain
What is the ECG presentation of Flutter
Regular rhythm with "Saw tooth" (F wave) 300bpm Narrow QRS Ventricular rate decreases with increased AV Block 2:1 Heart block
What is the first line management of flutter
Same as AF Electrical Cardioversion Pharmacological Cardioversion Rate control Ablation
What should be done to a haemodynamically unstable flutter patient
DC Cardioversion
What are the signs of Haemodynamic instability
Shock (End organ hypoperfusion)
Syncope (Brain hypoperfusion)
Chest pain (Myocardial ischemia)
Pulmonary oedema (Heart fail)
How would you manage a haemodynamically stable patient
Treat reversible causes such as sepsis and dehyrdation with IV fluids
Rate control with BB/CCB
If rate control fails attempt cardioversion
How would you manage recurring flutter
Catheter ablation of the cavotricuspid isthmus
Would you give anticoagulation in Flutter
YES, Follow CHADS2VASc
Chance of thromboembolism leading to a stroke
