Atrial Flutter

Atrial flutter is a rhythm that is similar to atrial fibrillation.

Unfortunately, the atria are firing at a rapid rate which affects
how they empty blood. Instead of contracting properly, they
cause blood to pool in the atria, and this could lead to the
formation of a blood clot. As a result of this, there is a risk of the
patient developing a blood clot which could cause a stroke.
This risk can also happen in atrial fibrillation.
 Characteristics and Criteria of Atrial flutter

No p-waves but flutter waves that look like a saw tooth

• The atria is firing very rapidly with an atrial rate of around 300 bpm. The atrial rate is regular.
• P-waves are NOT present, but abnormal p-waves that are termed flutter waves. These
waves have a saw-tooth appearance to them. (This is one of the key points with discerning
atrial fibrillation from atrial flutter.)
QRS complex measures less than 0.12 seconds.
• Ventricular rate will vary (it can regular or irregular)
• However, a too fast or slow ventricular rate will affect how well the heart can pump out
blood. Therefore, it’s important the rate is managed, hence under control.
• Can’t measure PR interval or QT interval or assess the t-waves.
 Causes of Atrial Flutter
Heart valve problems like with the tricuspid or mitral valves
Overactive thyroid
Pulmonary embolism
Cor pulmonale
Carditis
Digoxin toxicity

Clinical Manifestations:
Palpitations
Dyspnea
Pulmonary edema
 Treatment for Atrial Flutter
Medications: Calcium channel blockers (Diltiazem), Beta blockers (propranolol) or
Digoxin (if patient has heart failure) along with antiarrhythmics (Amiodarone).

• In addition, it’s important to prevent blood clot formation. Therefore, the patient
may need some type of anticoagulant like Warfarin.
• If the patient becomes unstable where the blood pressure is dropping, mental
status changes are occurring, chest pain, shortness of breath (signs indicating
decreased cardiac output), a synchronized cardioversion may be necessary.
• In some cases, if the rhythm is persistent an ablation may need to be performed.
This is a procedure that ablates (destroys) some of the tissue in the heart to
prevent it from firing irregularly.