1. Faisal A. Al Moaiqel http://www.slideshare.net/AlMoaiqel1
1
Atrial Flutter
(Atrial flutter is most easily seen in lead II , also aVR & aVF leads)
Introduction:
Atrial flutter is a common tachycardia (fast heart beat) that results from a rapid electrical
circuit in the atrium associate with irregular p­wave. It result from abnormal path for the electrical
impulse through the atria. That increase the contractility of atrium up to 250­350 beats per
minute. In other word, when the atrial pulse is over 250 bpm, and there is no flat baseline
between p­waves, “ atrial flutter ” is present. People with atrial flutter are more risky to get stroke.
Causes 1 :
The causes of Atrial flutter may divide into three main categories.
1. Conditions related to the heart :
a. Decreased blood flow to the heart due to ischemia or atherosclerosis.
b. Hypertension.
c. Cardiomyopathy.
d. hypertrophy of a chamber.
2. Diseases elsewhere in the body:
a. Hyperthyroidism.
b. Pulmonary embolism.
c. Chronic obstructive pumonary disease COPD or emphysema.
3. Substance may contribute to atrial flutter:
a. Alcohol.
b. Stimulants like: cocaine, amphetamines, cold medicine and even caffeine.
1
"Atrial Flutter Causes ­ eMedicineHealth." 2006. 4 Feb. 2013
<http://www.emedicinehealth.com/atrial_flutter/page2_em.htm>

2. Faisal A. Al Moaiqel http://www.slideshare.net/AlMoaiqel1
2
Signs and symptoms 2:
The electrical signal that causes atrial flutter circulates in an organized, predictable
pattern. This means that people with atrial flutter usually continue to have a steady heartbeat,
even though it is faster than normal. It is possible that people with atrial flutter may feel no
symptoms at all. Others do experience symptoms, which may include:
○ Heart palpitations (feeling like your heart is racing, pounding, or fluttering)
○ Fast, steady pulse
○ Shortness of breath
○ Trouble with everyday exercises or activities
○ Pain, pressure, tightness, or discomfort in your chest
○ Dizziness, lightheadedness, or fainting
Treatment 3 :
The treatment of atrial flutter is a treatment for tachycardia. Medication are often used to
slow heartbeat, it include: beta blocker, calcium channel blocker and digoxin. Patients with high
risk to stroke if they associate with certain factors. They prescribed to take warfarin and other
blood thinner.
There are 3 categories of treatment:
1. Electrical cardioversion:
It is a procedure involve putting the patient in sleep and deliver a brief electrical
shock. This procedure is very effective but the atrial flutter may recurrence in the future.
2. Antiarrhythmic drugs: May use after electrical cardioversion
3. Catheter ablation:
It involves the placement of catheters in the right atrium. These catheters may
then be used to create a small line of scar tissue that blocks the atrial flutter circuit.
Although this procedure is highly effective at eliminating atrial flutter and preventing future
recurrences, not everyone is a candidate for catheter ablation of atrial flutter.
People with a history of atrial flutter have a risk of developing these other forms of atrial
arrhythmias in the future. The treatment of atrial flutter may reduce, but not completely eliminate,
the risk of these other arrhythmias.
Thanks
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2
"Atrial Flutter (AFL) ­ Heart Rhythm Society." 2012. 4 Feb. 2013
<http://www.hrsonline.org/Patient­Resources/Heart­Diseases­Disorders/Atrial­Flutter>
3
Boyer, M. "Atrial Flutter ­ Circulation." 2005. <http://circ.ahajournals.org/content/112/22/e334.full>