Atrial flutter resident survival guide
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hilda Mahmoudi M.D., M.P.H.[2]
Definition
Atrial flutter is an abnormal heart rhythm that occurs in the atria of the heart.
Causes
Life Threatening Causes
Life-threatening causes include conditions which result in death or permanent disability within 24 hours if left untreated.
Common Causes
- Acute coronary syndromes
- Cardiomyopathy
- Congenital heart disease
- Hypertensive heart disease
- Hyperthyroidism
- Mitral valve disease[1] [2]
Management
Shown below is an algorithm summarizing the approach to atrial flutter.
Atrial flutter | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Unstable | Stable | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
CHF, shock, acute MI | Rate control: AV-nodal blockers | Conversion DC cardioversion Atrial pacing Pharmacological conversion | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
DC cardioversion | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
If therapy for prevention of recurrences warranted | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Antiarrhythmic drugs | Catheter ablation | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Algorithm based on the 2003 ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias[3]
References
- ↑ Gutierrez SD, Earing MG, Singh AK, Tweddell JS, Bartz PJ (2012). "Atrial Tachyarrhythmias and the Cox-maze Procedure in Congenital Heart Disease". Congenit Heart Dis. doi:10.1111/chd.12031. PMID 23280242. Unknown parameter
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ignored (help) - ↑ Granada, J.; Uribe, W.; Chyou, PH.; Maassen, K.; Vierkant, R.; Smith, PN.; Hayes, J.; Eaker, E.; Vidaillet, H. (2000). "Incidence and predictors of atrial flutter in the general population". J Am Coll Cardiol. 36 (7): 2242–6. PMID 11127467. Unknown parameter
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ignored (help) - ↑ "ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias—Executive Summary". Retrieved 15 August 2013.