Atrial Flutter

Creado por team@ekgdx.com el 12 de Febrero de 2023

Let’s talk about atrial flutter.

Atrial flutter is an arrhythmia resulting from reentry in a macroreentrant circuit, most commonly in the right atrium. It is characterized by regular atrial activity with “sawtooth” appearance.

Criteria

  • Atrial rate usually 300/min (usual range 250-350 bpm).
  • “F” waves with “sawtooth” appearance, best seen in inferior leads and V1.
  • Absence of baseline.
  • PR interval unmeasurable.

 

Same rhythm strip with graphical explanation. 

 

Note the negative fluter waves (F waves) with AV conduction ratio of 2:1 and ventricular rate of ~150 bpm.

 

Atrial Flutter

Another example with clear F waves.

 

Atrial flutter with 2:1 conduction.

 

NOTE: Odd ratios (1:1, 3:1, 5:1) are really uncommon.

NOTE: Atrial flutter is probably the most overlooked arrhythmia. 

NOTE: The most common AV ratio is 2:1, resulting in a ventricular rate of ~150 bpm.

NOTE: Atrial flutter can be typical or atypical depending on whether the cavotricuspid isthmus (CTI) participates or not in the reentrant circuit.

NOTE: Atrial flutter with 1:1 conduction and wide QRS is rare but often mistaken for ventricular tachycardia.

NOTE: Atrial flutter may presents with variable AV conduction, particularly after receiving cardiac medications.

Possible causes: The same as for atrial fibrillation

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References

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Thanks for joining us. 

Dr. Roig

Atrial Flutter