ECG: A Case of Flutter-Fibrillation
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ECG: A Case of Flutter-Fibrillation

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    ECG: A Case of Flutter-Fibrillation ECG: A Case of Flutter-Fibrillation Presentation Transcript

    • ECG OF THE WEEK. PROF .DR.P.VIJAYARAGHAVAN’S UNIT. DR.A.KARTHICK RAMALINGAM.
    • Clinical summary.
      • 70 year old Mrs. Devasundari was admitted with
      • C/o Chest pain,
      • Palpitation,
    •  
    •  
    • ECG FINDINGS
      • Atrial rate 340/min
      • Ventricular Rate 60/ min.
      • Axis +60.
      • P waves having morphology intermediate between that of flutter and fibrillation waves.
      • Rhythm strip shows flutter/fibrillation waves
      • No ST , T wave abnormalities seen .
      • IMP:
        • Flutter - fibrillation
        • Atrial flutter is of type I . (Flutter waves are of uniform morphology)
        • Clockwise conduction. (Positive F wave II,III,aVF).
    • Atrial flutter
      • It’s a supraventricular tachycardia caused by reentrant rhthym either in left or right atrium.
      • Atrial rate will be around 240 to 400/ min.
      • Two types:
      • Type 1 or classic form is more common. Involves a single reentrant circuit .
      • Type II (atypical) Atypical atrial flutters . Has a rate faster than type I
    • TYPE I FLUTTER
    • TYPE I FLUTTER
    • Anticlockwise and Clockwise
    • OTHER REENTRANT CIRCUITS
    • Treatment
      • General goals for the treatment of symptomatic atrial flutter are similar to those for atrial fibrillation and include the following:
      • Control of the ventricular rate
      • Restoration of sinus rhythm
      • Prevention of recurrent episodes, or decrease in their frequency or duration
      • Prevention of thromboembolic complications
      • Minimization of adverse effects from therapy
    • TYPE I FLUTTER
      • If pt is clinically stable : consider ventricular rate control and elective ablative therapy of the circuit.
      • If pt is hemodynamically compromised : cardioversion immediately or after anticoagulation depending on duration of A. flutter followed by elective abalative therapy. ELECTRICAL CARDIOVERSION IS PREFFERED
      • Post ablation pt may or maynot nead antiarrythymics depending on effectiveness of ablation.
    • TYPE II FLUTTER
      • Ablation can be done in higher centers with facilities to map the circuit .
    • CATHETER ABLATION
    • THANK YOU