- Atrial dysrhythmia (most commonly with atrial rate of 300 with a 2:1 block leading to a ventricular rate of 150)
- Estimated 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
- Cardiomyopathies and myocarditis
- Electrolyte abnormalities
- Ischemic heart disease
- Pulmonary embolus and other pulm diseases
- Valvular heart diseases
- Post op following cardiac surgery (often in first postoperative week)
- 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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Schaider, Jeffrey J., 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: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307169/all/Atrial_Flutter. Accessed June 9, 2023.
Atrial Flutter. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307169/all/Atrial_Flutter
Atrial Flutter [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 June 09]. 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 - Barkin,Adam Z, ED - Shayne,Philip, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Wolfe,Richard E, 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 -