Sandbox vidit: Difference between revisions

Revision as of 20:21, 11 March 2014

Shown below is an algorithm summarizing the therapeutic approach to atrial flutter.^[1]

Unstable

Stable

❑ Look for the presence of any of these:

❑ Chronic heart failure

❑ Hypotension

❑ Acute myocardial infarction

Proposed therapy	Recommendation
Conversion	DC cardioversion (class I, level of evidence C)
Rate control	Beta blockers (class I, level of evidence C) or Verapamil or diltiazem (class I, level of evidence A) or Digitalis (class IIb, level of evidence C) or Amiodarone (class IIb, level of evidence C)

❑ Administer anticoagulation therapy based on the risk of stroke, if total duration of flutter > 48 hours

Proposed therapy	Recommendation
Conversion	Atrial or transesophageal pacing (class I, level of evidence A) or DC cardioversion (class I, level of evidence C) or Ibutilide (class IIa, level of evidence A) Flecainide (class IIb, level of evidence A) Propafenone (class IIb, level of evidence A) Sotalol (class IIb, level of evidence C) Procainamide (class IIb, level of evidence A) Amiodarone (class IIb, level of evidence C)
Rate control	Beta blockers (class I, level of evidence C) or Verapamil or diltiazem (class I, level of evidence A) or Digitalis (class IIb, level of evidence C) or Amiodarone (class IIb, level of evidence C)

❑ Assess need for therapy to prevent recurrence

❑ Administer antiarrythmic therapy to prevent recurrences

❑ Consider catheter ablation if antiarrhythmic therapy fails

@@ Line 10: / Line 10: @@
 :❑ 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> DC cardioversion ([[ACC AHA guidelines classification scheme|class I, level of evidence C]])
+<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>|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">