Most patients with atrial flutter should be considered for long-term anticoagulation in a manner similar to those with atrial fibrillation (AF). On entend sous le terme général de FA: la fibrillation auriculaire et, par extension, le flutter auriculaire et la tachycardie atriale. Dans le cadre de ce guide, sont. notation. prefLabel. Atrial flutter. SMQ TERM LEVEL. 4. tui. T subClassOf.

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Pacing may induce AF or a faster flutter type II flutter75 probably as an expression of functional re-entry 76 that tends to auricuoaire to baseline flutter or change to AF.

Surface electrocardiographic patterns and electrophysiologic characteristics of atrial flutter following modified radiofrequency MAZE procedures.

Initial energy setting, outcome and efficiency in direct current cardioversion of atrial fibrillation and flutter. In patients with RA surgical atriotomy, the scar can become the centre of the MRT, but the small incisions used to cannulate the superior vena cava and IVC are rarely arrhythmogenic by themselves. Anatomic and electrophysiologic differences between chronic and paroxysmal atrial flutter: Left atrial flutter is considered atypical and is common after incomplete left atrial ablation procedures.

N Engl J Med ; Atrial flutter AFL is a common abnormal heart rhythm that starts in the atrial chambers of the heart. The addition of rate-controlling drugs or conduction system disease can increase this block substantially see image below. So for example here, we have the focus firing, causing the atria to contract, it hits AV node, conducts, makes QRS complex and it tries to fire again but because we’re in the refractory period it’s not going to conduct through the AV node and you’re not going to get another QRS complex.

Atrial Flutter, Typical and Atypical: A Review

Right atrial flutter due to lower loop reentry: Overdrive atrial pacing for conversion of atrial flutter: Circus movement atrial flutter in the canine sterile pericarditis model.

In flurter subjected to cardiac surgery or catheter ablation for the treatment of atrial fibrillation or showing atypical ECG patterns, macro-re-entrant and focal tachycardia mechanisms can be very complex and electrophysiological studies are necessary to guide ablation treatment in poorly tolerated cases.

Experimental studies on auriculairre flutter and auricular fibrillation. Heart Rhythm ; 7: In cases of atypical MRT of the RA, CTI ablation could be considered even if typical flutter is not documented in order to prevent the later appearance of typical flutter.


Aggressive risk factor reduction study for atrial fibrillation and implications for augiculaire outcome of ablation: Global right atrial mapping of human atrial flutter: Fibrillar contraction of the heart.

Pulseless electrical activity PEA and asystole.

A first and well-tolerated episode of flutter terminated spontaneously or by electrical cardioversion or AAD can be followed clinically aurifulaire or without AAD coverage. Prolonged atrial flutter ahriculaire fast heart rates may lead to decompensation with loss of normal heart function heart failure.

The electrical signal travels around in a circular pattern and moves around again, and again, and again, and again, and again. Individual flutter waves may be symmetrical, resembling p-waves, or may be asymmetrical with a “sawtooth” shape, rising gradually and falling abruptly or vice versa.

The poor results of rhythm control strategies in AF may not apply in flutter because of a lower recurrence rate after cardioversion in flutter, making a strategy of repeated cardioversions supported with AADs a clinically applicable option.

Because both rhythms can lead to the formation of a blood clot in the atrium, flugter with atrial flutter usually require some form of anticoagulation or antiplatelet agent.

Accelerated idioventricular rhythm Catecholaminergic polymorphic Torsades de pointes.

This page was last edited on 30 Julyat In atrial flutter, there’s a really irritable automaticity focus and I’m drawing that here in purple. So classic A flutter is said to have a saw tooth pattern and the saw teeth are the P waves.

Atrial flutter – Wikipedia

Now remember that the heart’s dominant pacemaker is the SA node and the SA node is going to send the signal to the AV node which will then conduct the signal down to the lower half of the heart which makes the ventricles contract. Heart rate is a measure of the ventricular rather than atrial activity. Which circuits to expect in which substrate? Retrieved from ” https: Intraatrial reentry as a mechanism for atrial flutter induced by acetylcholine and rapid pacing in the dog.

Atrial flutter (AFL)

The author has no conflicts of interest to declare. Am J Med ; These backup pacers only fire in the event that the signal from the SA node is not efficiently or effectively reaching the AV node and when they do fire, they fire at a rate between 60 and 80 beats per minute or BPM. Endurance sport practice as a risk factor for atrial fibrillation and atrial flutter. Thus, any thrombus material that dislodges from this side of the heart can embolize break off and travel to the brain’s arteries, with the potentially devastating consequence of a stroke.


Mapping and entrainment studies are necessary to define the focal centrifugal spread or MRT mechanism and localise the focal sources or the target isthmus or isthmuses. Results from a single-blind, randomized study comparing the impact of different ablation approaches on long-term procedure outcome in coexistent atrial fibrillation and flutter APPROVAL. Lesional tachycardias related to mitral valve surgery. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.

Arch Inst Cardiol Mex ; Left Atrial Macro-re-entrant Tachycardias Surgical atriotomy scars are a well-known cause of MRT of the LA — often combined with re-entry around low-voltage, inexcitable areas not related to atriotomy. MRT circuits turning around the superior vena cava and part of the terminal crest, not involving the CTI, can occasionally be found in patients without surgical atriotomy see Figure 7.

Catheter ablation of scar-related atypical atrial flutter. Recent reports have shown that physical fitness programmes and vigorous treatment of obesity, metabolic syndrome and sleep apnoea can result in a significant reduction in AF recurrence in patients whether or not they undergo AF ablation, — and this may be applicable to flutter given the very similar risk factor profiles. D ICD – Flutter cardioversion by pacing is painless and can be done without sedation or anaesthesia.

In patients without a history of heart disease, cardiac surgery or catheter ablation, typical flutter ECG remains predictive of a right atrial re-entry circuit dependent on the inferior vena cava—tricuspid isthmus that can be very effectively treated by ablation, although late incidence of atrial fibrillation remains a problem.

Search form Search this site. Variable electrocardiographic characteristics of isthmus-dependent atrial flutter. J Cardiovasc Electrophysiol ; 9: