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Atrial Flutter

Atrial Flutter is a topic covered in the 5-Minute Emergency Consult.

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  • Atrial dysrhythmia
  • 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
  • Seldom occurs in the absence of organic heart disease
  • Less common than supraventricular tachycardia (SVT) or atrial fibrillation
  • Typically paroxysmal, lasting seconds to hours
  • Occurs in ∼25–35% of patients with atrial fibrillation
  • Untreated, may promote cardiomyopathy


  • Alcoholism
  • Cardiomyopathies and myocarditis
  • CHF
  • Electrolyte abnormalities
  • Ischemic heart disease
  • Pulmonary embolus and other pulm diseases
  • Valvular heart diseases
  • Post op following cardiac surgery (often in 1st postoperative week)
  • Thyrotoxicosis

Pediatric Considerations
  • Occurs in children but is often asymptomatic
  • Associated mortality is highest in the neonatal period.
  • Associated with:
    • Congenital heart disease
    • Infectious etiologies, such as rheumatic fever or myocarditis
  • Be sure to consider potential toxic ingestions in pediatric patients with new AV block

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Rosen, Peter, et al., editors. "Atrial Flutter." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307169/all/Atrial_Flutter.
Atrial Flutter. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307169/all/Atrial_Flutter. Accessed April 23, 2019.
Atrial Flutter. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307169/all/Atrial_Flutter
Atrial Flutter [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307169/all/Atrial_Flutter.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Atrial Flutter ID - 307169 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307169/all/Atrial_Flutter PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -