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===Therapeutic Approach=== | |||
Shown below is an algorithm summarizing the therapeutic approach to [[atrial flutter]].<ref name="circ.ahajournals.org">{{Cite web | last = | first = | title = ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias—Executive Summary | url = http://circ.ahajournals.org/content/108/15/1871 | publisher = | date = | accessdate = 15 August 2013 }}</ref> | |||
{{familytree/start}} | |||
{{familytree | | | | | | | A01 | | | | | | | | | | |A01=[[Atrial flutter]] }} | |||
{{familytree | | | |,|-|-|-|^|-|-|-|.| | | | | | | | }} | |||
{{familytree | | | B01 | | | | | | B02 | | | | | | |B01=Unstable |B02=Stable }} | |||
{{familytree | | | |!| | | | | | | |!| | | | | | | | }} | |||
{{familytree | | | C01 | | | | | | C02 | | | | | | |C01=<div style="float: left; text-align: left; padding:1em;">❑ Look for the presence of any of these: <br> | |||
:❑ Chronic heart failure | |||
:❑ Hypotension | |||
:❑ Acute myocardial infarction <br> | |||
</div>|C02=<div style="float: left; text-align: left; padding:1em;"> ❑ Administer anticoagulation therapy based on the risk of stroke, if total duration of flutter > 48 hours <br> | |||
<table class="wikitable"> | |||
<tr class="v-firstrow"><th>Proposed therapy</th><th>Recommendation</th></tr> | |||
<tr><td>Conversion</td><td>Atrial or transesophageal pacing ([[ACC AHA guidelines classification scheme|class I, level of evidence A]])<br> or <br>DC cardioversion ([[ACC AHA guidelines classification scheme|class I, level of evidence C]])<br> or <br> Ibutilide ([[ACC AHA guidelines classification scheme|class IIa, level of evidence A]])<br> Flecainide ([[ACC AHA guidelines classification scheme|class IIb, level of evidence A]]) <br>Propafenone ([[ACC AHA guidelines classification scheme|class IIb, level of evidence A]]) <br> Sotalol ([[ACC AHA guidelines classification scheme|class IIb, level of evidence C]]) <br> Procainamide ([[ACC AHA guidelines classification scheme|class IIb, level of evidence A]]) <br> Amiodarone ([[ACC AHA guidelines classification scheme|class IIb, level of evidence C]]) </td></tr> | |||
<tr><td>Rate control</td><td>[[Beta blockers]] ([[ACC AHA guidelines classification scheme|class I, level of evidence C]])<br> or <br> [[Verapamil]] or [[diltiazem]] ([[ACC AHA guidelines classification scheme|class I, level of evidence A]])<br> or <br> [[Digitalis]] ([[ACC AHA guidelines classification scheme|class IIb, level of evidence C]]) <br> or <br> [[Amiodarone]] ([[ACC AHA guidelines classification scheme|class IIb, level of evidence C]])</td></tr> | |||
</table> </div> }} | |||
{{familytree | | | |`|-|-|-|v|-|-|-|'| | | | | | | | }} | |||
{{familytree | | | | | | | D01 | | | | | | | | | | |D01=<div style="float: left; text-align: left; padding:1em;"> ❑ Assess need for therapy to prevent recurrence </div> |D02=}} | |||
{{familytree | | | | | | | |!| | | | | | | | | | | | }} | |||
{{familytree | | | | | | | E01 | | | | | | | | | | |E01=<div style="float: left; text-align: left; padding:1em;"> ❑ Administer antiarrythmic therapy to prevent recurrences | |||
---- | |||
❑ Consider catheter ablation if antiarrhythmic therapy fails </div>}} | |||
{{familytree/end}} | |||
Revision as of 20:18, 11 March 2014
Therapeutic Approach
Shown below is an algorithm summarizing the therapeutic approach to atrial flutter.[1]
| Atrial flutter | |||||||||||||||||||||||||||||||||||||||||||
| Unstable | Stable | ||||||||||||||||||||||||||||||||||||||||||
❑ Look for the presence of any of these:
| ❑ Administer anticoagulation therapy based on the risk of stroke, if total duration of flutter > 48 hours
| ||||||||||||||||||||||||||||||||||||||||||
❑ Assess need for therapy to prevent recurrence | |||||||||||||||||||||||||||||||||||||||||||
❑ Administer antiarrythmic therapy to prevent recurrences
❑ Consider catheter ablation if antiarrhythmic therapy fails | |||||||||||||||||||||||||||||||||||||||||||
- ↑ "ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias—Executive Summary". Retrieved 15 August 2013.