Q: What are the chances of the formation of thrombus in the atrial cavity in the case of long-standing atrial flutter? Do we have to give anticoagulation, as in atrial fibrillation, to minimize the risk of emboli?Ī: The chances for thrombus formation are relatively high. (3.84 mb)Ĭlick for next Rhythm Review: Atrial Fibrillation Questions Asked On This Page Please allow several seconds for the video to load. 20-50J is commonly enough to revert to sinus rhythm.ĪHA recommends an initial shock dose 0f 50-100 J for cardioverting unstable atrial flutter.īelow is a short video which will help you quickly identify atrial flutter on a monitor. CardioversionĪtrial flutter is considerably more sensitive to electrical direct-current cardioversion than atrial fibrillation, and usually requires a lower energy shock. Drugs are not used to manage unstable tachycardia. When atrial flutter produces hemodynamic instability and serious signs and symptoms, it is treated using ACLS protocol.įor the patient with unstable tachycardia due to this tachyarrhythmia (atrial flutter), immediate cardioversion is recommended. Treatmentįor the purposes of ACLS, atrial flutter is treated the same as atrial fibrillation. Prevent complications from atrial flutter with early cardioversion. Ineffective atrial contractions can lead to thrombus formation in the atria and rapid ventricular rates can cause decompensation and heart failure. These complications are usually due to ineffective atrial contractions and rapid ventricular rates. symptoms of heart failure such as activity intolerance and swelling of the legs occur with prolonged fast flutter)Īs with its symptoms, atrial flutter shares the same complications as atrial fibrillation.nervousness and feelings of impending doom.Symptoms of atrial flutter are similar to those of atrial fibrillation and may include the following: Usually, with atrial flutter, not all of the atrial impulses will be conducted to the ventricles, and the more atrial impulses that are conducted, the greater the negative effect. The impact and symptoms of atrial flutter depend upon the ventricular rate of the patient (i.e. These rapid atrial rates are caused by electrical activity that moves in a self-perpetuating loop within the atria. Atrial flutter is typically not a stable rhythm and will frequently degenerate into atrial fibrillation.Ītrial Flutter will usually present with atrial rates between 240-350 beats per minute. The faster the ventricular response, the more the circulation will be compromised.Atrial flutter is an abnormal heart rhythm that technically falls under the category of supra-ventricular tachycardias. This is especially true when atrial flutter is accompanied by a syndrome called rapid ventricular response. Similarly to how atrial fibrillation complicates ventricular preload filling, atrial flutter complicates circulation. Are the QRS complexes similar in appearance?Ītrial flutter is usually caused by structural heart disease.Is the QRS interval less than 0.12 seconds?.Does the PR interval fall within the normal 0.12-0.20 seconds?.Are the P waves smooth, rounded, and upright?.No, there is no P wave for each QRS complex.Is there one P wave for each QRS complex?.No, because there are no real SA node P waves.Anything closely resembling a P wave is actually a sawtooth-type F wave.The rate is variable because of its irregularity.Variable, depending on the ratio of F waves to QRS complexes.To interpret an ECG, ask the following questions: Rhythm Because of the abnormal depolarization of the atria, the flutter waves resemble a sawtooth pattern. So, instead of P waves, atrial flutter produces flutter (F) waves. Due to this erratic electrical activity, the normal function of the SA node is usually suppressed and non-effective. This ectopic pacemaker usually originates somewhere in the lower atrium and closer to the AV node, making a distinct wave pattern. This is the result of an ectopic atrial pacemaker or because of a rapid reentry pathway somewhere within the atria but outside of the SA node area. On an ECG, atrial flutter resembles F waves with a sawtooth pattern.
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