EKG
Atrial Flutter
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Atrial Flutter
See Also
Atrial Fibrillation
Atrial Fibrillation Causes
Electrocardiogram in Atrial Fibrillation
Atrial Fibrillation Acute Management
Atrial Fibrillation Anticoagulation
Atrial Fibrillation Cardioversion
Atrial Fibrillation Rate Control
Types
Type I Atrial Flutter (typical)
Constant atrial rate of 240 to 350 beats per minute
Ventricular rate will usually be at least a 2:1 block (
AV Node
prevents rates above 180)
Natural rate is altered by age, atrial dilation and
Antiarrhythmic
s (esp Type Ia or Type Ic)
Type II
Constant atrial rate at 340 to 440 beats per minute (Faster Atrial Flutter rate than with Type I)
Differs from Type I in reentry accessory path
Signs
Constant atrial rate
Atrial to ventricular rates may range from 1:1 to 4:1
Atrial to ventricular rate 2 to 1 (most common)
Atrial rate of 240 to 350 beats per minute
Ventricular rate 140-150 beats per minute
Diagnostics
EKG
Constant atrial rate
Atrial rate: 300 per minute (typical)
Atrial to ventricular rate
Ratio 1:1 - 300 bpm (Rare, but potentially lethal)
Ratio 2:1 - 150 bpm (most common)
Ratio 4:1 - 75 bpm
Saw tooth flutter waves
May be difficult to visualize at a 2:1
AV Block
(rate 140-150) due to overlapping
QRS Complex
with flutter wave
Increase EKG "paper speed" to 50 mm/sec (rapid) to spread out complexes (
P Wave
s may be seen)
Images
Management
See
Atrial Fibrillation
Management
Highly responsive to
Synchronized Cardioversion
at low energy levels
Dr. Amal Mattu (paraphrased): "you could rub your shoes together to shock Atrial Flutter back to sinus"
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