200,000 new cases each year
A macroreentrant circuit in the right atrium is thought to be the underlying mechanism.
Most sensitive rhythm to cardioversion
Poor exercise capacity
Tachycardia—HR >150 bpm:
Infants do not tolerate atrial flutter well.
Oxygen, monitor, IV access
Unstable patients should be cardioverted in the field:
Immediate synchronized cardioversion
Start with 100 J
Oxygen, monitor, ...
New-onset atrial flutter requiring antidysrhythmics, rate control
Symptomatic (i.e., chest pain that warrants a rule out or cardioversion)
Be aware of WPW:
Do not use adenosine, β-blockers, calcium channel blockers, and digoxin (Class III can be harmful).
Can cause increased ventricular response, which can deteriorate t...
Clausen H, Theophilos T, Jackno K, et al. Paediatric arrhythmias in the emergency department. Emerg Med J. 2012;29(9):732–737.
Fuster V, Ryden LE, Cannom DS, et al. ACC/A...
I48.3 Typical atrial flutter
I48.4 Atypical atrial flutter
I48.92 Unspecified atrial flutter
5370000 Atrial flutter (disorder)
427665004 paroxysmal atrial flutte...
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