7. Atrial Flutter

  1. David H. Bennett MD FRCP

Published Online: 1 NOV 2012

DOI: 10.1002/9781118432389.ch7

Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition

Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition

How to Cite

Bennett, D. H. (2013) Atrial Flutter, in Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition, John Wiley & Sons, Ltd, Oxford. doi: 10.1002/9781118432389.ch7

Author Information

  1. Senior Consultant Cardiologist, University Hospital of South Manchester, Manchester, UK

Publication History

  1. Published Online: 1 NOV 2012
  2. Published Print: 14 JAN 2013

ISBN Information

Print ISBN: 9780470674932

Online ISBN: 9781118432389

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Keywords:

  • Atrial flutter;
  • Atrioventricular conduction;
  • ECG characteristics;
  • Intraventricular conduction;
  • Systemic embolism;
  • Treatment

Summary

Typical atrial flutter is a common arrhythmia caused by a re-entrant circuit within the right atrium, usually in a counterclockwise direction. It may be paroxysmal or sustained. Atrial activity is registered as F waves at a regular rate in the order of 300 beats/min. Commonly, alternate F waves are conducted to the ventricles with a resultant ventricular rate close to 150 beats/min. In many ECG leads there will be no isoelectric line between atrial deflections, leading to the characteristic sawtooth appearance that is best seen in leads II, III and aVF. However, in lead V1 atrial activity will usually be seen as discrete waves.

Atrial flutter has similar causes to atrial fibrillation. It is often idiopathic. Antiarrhythmic drugs are frequently ineffective and may sometimes cause an increase in ventricular rate. Cardioversion and catheter ablation are both first-line treatments. Embolic risk should be managed as for atrial fibrillation.