Atrial flutter electrocardiogram: Difference between revisions
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==Electrocardiogram== | ==Electrocardiogram== | ||
Findings on an ECG suggestive of atrial flutter include: | Findings on an ECG suggestive of atrial flutter include: | ||
*There are rapid regular undulations (F waves) that cause a sawtooth appearance. | |||
** Best seen in leads [[Electrocardiogram#Limb|II]], [[Electrocardiogram#Limb|III]], [[Electrocardiogram#Augmented limb|aVF]] and [[Electrocardiogram#Precordial|V1]]. | |||
** Usually inverted in the inferior leads. | |||
** No isoelectric baselines between the F waves. | |||
*Atrial rate is 250 to 350 Beats Per Minute (BPM). | |||
** Can be faster in infants and children. | |||
** Massive dilation of the atria can lead to a rate < 200 BPM. | |||
** [[Quinidine]] can reduce the atrial rate. | |||
*There is a variable ventricular rate depending on the AV conduction. | |||
** The most common response is 2:1 | |||
** 3:1 is uncommon | |||
** 4:1 suggests the existence of an AV conduction defect | |||
** May be associated with [[complete AV block]] in which case the RR intervals are regular and the F waves have no constant relationship to the [[QRS]]. The ventricular response is usually slow. | |||
** 1:1 conduction may be precipitated by excitement, exercise, induction of [[anesthesia]] or any increase in sympathetic tone. | |||
*It may occur in [[WPW]] where the impulses are conducted antegrade through the bypass tract. All these are an emergency. | |||
** During treatment with [[quinidine]] the atrial rate may slow sufficiently to permit 1:1 conduction. | |||
** Vagal maneuvers increase the degree of [[AV block]]. | |||
*QRS either normal or aberrant depending on preexisting [[IVCD]] or aberrant ventricular conduction. | |||
==EKG Examples== | ==EKG Examples== | ||
Revision as of 17:06, 4 December 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Characteristic electrocardiographic findings in a patient with atrial flutter include; an atrial rate from 250-350 beats per minute, a "sawtooth" appearance to the tracings due to rapid regular undulations (F waves), and a variable ventricular rate depending on AV conduction.
Electrocardiogram
Findings on an ECG suggestive of atrial flutter include:
- There are rapid regular undulations (F waves) that cause a sawtooth appearance.
- Atrial rate is 250 to 350 Beats Per Minute (BPM).
- Can be faster in infants and children.
- Massive dilation of the atria can lead to a rate < 200 BPM.
- Quinidine can reduce the atrial rate.
- There is a variable ventricular rate depending on the AV conduction.
- The most common response is 2:1
- 3:1 is uncommon
- 4:1 suggests the existence of an AV conduction defect
- May be associated with complete AV block in which case the RR intervals are regular and the F waves have no constant relationship to the QRS. The ventricular response is usually slow.
- 1:1 conduction may be precipitated by excitement, exercise, induction of anesthesia or any increase in sympathetic tone.
- It may occur in WPW where the impulses are conducted antegrade through the bypass tract. All these are an emergency.
- QRS either normal or aberrant depending on preexisting IVCD or aberrant ventricular conduction.
EKG Examples
Shown below is an EKG with an alternating 2:1 and 3:1 atrial flutter.
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:Aflutr_ecg.jpg
Shown below is an EKG depicting atrial flutter.
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/Main_Page
Shown below is an EKG of a 2:1 atrial flutter.
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:ECG_Aflutt.jpg
Shown below is an EKG of a 2:1 atrial flutter.
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/Main_Page
- For more EKG examples of atrial flutter click here.