Atrial flutter medical therapy

Atrial flutter Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

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Overview

The management of atrial flutter is similar to that of atrial fibrillation with primary goals being control of ventricular rate, restoration of sinus rhythm, prevention of recurrent episodes and thromboembolic episodes. In the setting of unstable hemodynamics immediate electrical cardioversion is recommended. because of the high success rate and low complication rate radiofrequency ablation is considered superior to medical therapy in atrial flutter.

Medical Therapy

Management of Atrial Flutter in Emergency Department

Management of atrial flutter in emergency room depends on the hemodynamic state of the patient. Airway, breathing an circulation should be assessed first. Hemodynamically unstable patients are treated by electrical cardioversion. Ottawa Aggressive Protocol is a unique approach to cardioversion for ED patients with recent-onset episodes of atrial fibrillation and flutter. This approach is effective, safe and rapid and has the potential to reduce hospital admissions and expedite ED care. Treatment options in ED include:

• Electric cardioversion
• Chemical cardioversion
• Rapid atrial pacing

Electric Cardioversion

Synchronous direct current (DC) cardioversion is used as the initial treatment in the management of atrial flutter in ED.

References

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