What Is an Atrial Flutter?

Atrial flutter can be thought of as an intermediate pattern between atrial tachycardia and atrial fibrillation. When the frequency of atrial ectopic pacing points reaches 250 to 350 beats per minute and is regular, the rapid and coordinated contraction of the atrium is called atrial flutter. Patients may develop hypotension, dizziness, palpitations, angina, and even cardiogenic shock.

Basic Information

English name

thoracicoutletsyndrome

Visiting department

Thoracic Surgery

Common symptoms

Pain, numbness

Contagious

no

Causes of atrial flutter

Most are organic heart disease, common in coronary heart disease, hypertension, pulmonary heart disease, pulmonary embolism, and sick sinoatrial node.

Atrial flutter clinical manifestations

1. When the atrial flutter is passed down 1: 1 (mostly in infants and young children), the ventricular rate can be as fast as 250 times / minute, and hypotension, dizziness, palpitations, angina pectoris, and even cardiogenic shock can occur.

2. The jugular vein beats faster than the ventricular rate.

3. Auscultation of the heart, the most common is a fast and regular heart rate, about 150 beats per minute, and the atrioventricular ratio is 2: 1. When the ratio of the atrioventricular is 3: 1 or 4: 1, the heart rate slows down. At this time, you can hear fast and low atrial contraction when you carefully auscultate.

Atrial flutter

1. Patients with primary diseases such as rheumatic heart disease and pulmonary heart disease infection may have an increased white blood cell count.

2. Pulmonary heart disease patients have lung infections and abnormal X-rays.

3. The main means of confirming the diagnosis depend on the electrocardiogram, which is characterized by:

(1) The P wave disappears in the ECG examination, and the shape, spacing, and amplitude are absolutely neat and sawtooth-like F waves, with a frequency of 250 to 350 times / minute. The common atrial flutter is mostly 2: 1 conduction.

(2) ECG characteristics can be divided into two types: type flutter wave frequency is about 300 times / minute, , , aVF lead F wave is negative, type flutter wave frequency is 250 times / minute, , , aVF lead F wave erect, pacing therapy can terminate type , but not effective for type .

(3) When atrial flutter is accompanied by indoor differential conduction, bundle branch block, or pre-excitation syndrome, attention should be paid to distinguishing from ventricular tachycardia.

Atrial flutter treatment

1. Simultaneous direct current cardioversion is preferred for patients with pre-excitation syndrome with atrial flutter or with heart failure and urgent cardioversion of cardiogenic shock, with a 1: 1 atrioventricular conduction ventricular rate of 200 times per minute or more, which should be preferred Electricity conversion is generally 50 100Ws, and the success rate is 100%.

2. Ventricular rate too fast can be given intravenous injection of lanatoside C (cedilan), which can first become atrial fibrillation and then revert to sinus rhythm.

3. Intravenous or oral amiodarone can also achieve good results.

4. Propafenone (cardiac rhythm), quinidine, propidamine (diisopramine), sotalol, flukanyl, etc. can be converted to atrial flutter.

5. Individuals with chronic atrial flutter who can't be cardioversion using the above method can be administered orally with digitalis or verapamil (Vapiridine) (except for heart failure).

6. Transcatheter radiofrequency ablation is effective in treating most patients.

Atrial flutter prognosis

Atrial fibrillation and atrial flutter mostly occur in coronary heart disease, hypertensive heart disease, pulmonary heart disease, hypokalemia, acute lung infection or digitalis poisoning, etc. Therefore, the cause should be investigated first and the underlying disease should be actively treated . Generally before atrial fibrillation or atrial flutter occurs, if frequent atrial premature occurs, it should be actively treated to prevent the development of atrial fibrillation or atrial flutter.