This presentation is about atrial flutter,its causes, electrocardiograph features and management.

1. ‫الرحیم‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬

2. ATRIAL FLUTTER
CAUSES, ELECTROCARDIOGRAPHIC FEATURES AND
MANAGEMENT

3. DEFINITION
• ATRIAL FLUTTER IS CHARACTERIZED BY A REGULAR, RAPID ATRIAL RATE OF 250-350/MINUTE,
WHERE VENTRICLES RESPOND TO EVERY SECOND, THIRD OR FOURTH BEAT (2: 1, 3: 1 OR 4: 1 AV
BLOCK).
• COMMON CAUSES
• ORGANIC HEART DISEASES (ISCHEMIC, RHEUMATIC, CONGENITAL)
• PERICARDITIS
• ACUTE RESPIRATORY FAILURE
• FIRST WEEK FOLLOWING OPEN HEART SURGERY
• ELECTROCARDIOGRAPIC FEATURE
• CHARACTERISTIC FLUTTER WAVES ARE SEEN AS REGULAR SAW-TOOTHED WAVES ("F" WAVES).

4. MANAGEMENT
• IMMEDIATE CONVERSION TO SINUS RHYTHM CAN BE ACCOMPLISHED BY DIRECT
CURRENT CARDIOVERSION OR ATRIAL PACING.
• INITIAL REDUCTION OF VENTRICULAR RATE USING DIGOXIN, DILTIAZEM, BETA-
BLOCKERS OR VERAPAMIL FOLLOWED BY CONVERSION TO SINUS RHYTHM USING
QUINIDINE, AMIODARONE, DISOPYRANIMIDE OR FLECAINIDE.
• PREVENTION OF RECURRENCES CAN BE ACCOMPLISHED BY QUINIDINE,
AMIODARONE, DISOPYRAMIDE OR FLECAINIDE.
• THE STROKE RISK IS SIMILAR TO THAT FOR ATRIAL FIBRILLATION AND THE
MANAGEMENT OF ANTICOAGULATION IS ALMOST IDENTICAL BUT MAY BE STOPPED
EARLIER AFTER SUCCESSFUL ABLATION.