Patologická fyziologie orgánových systémů : Část I. 1. STÁREK, Zdeněk. Katetrizační léčba typického flutteru síní včera a dnes.antiarrhythmic drugs, heart rate controlling drugs ( beta-blockers, verapamil, digoxin).external electrical cardioversion, which is usually necessary to terminate the arrhythmia.In addition to catheter ablation, the following may also be used in the treatment of flutter: If you have it, your doctor will classify yours by the reason for it and on how long it lasts. The method of choice for the treatment of atrial flutter is catheter radiofrequency ablation of the cavotricuspid isthmus, during which we use radiofrequency energy to create linear lesions across the isthmus with the goal of achieving bidirectional isthmus blockade and interruption of the reentry circuit. Atrial fibrillation ( AFib) is a type of irregular heartbeat. A very rare complication of atrial flutter is sudden cardiac death'. In the case of unblocked atrial flutter, each atrial contraction is converted to ventricular, resulting in tachycardia with subsequent myocardial exhaustion and the development of tachycardia cardiomyopathy (cardiac dilatation, reduced left ventricular systolic function, left-sided heart failure). The main complication of atrial flutter is thromboembolism, more rarely it may be tachycardia cardiomyopathy. The AV node passes every second impulse in an attempt to protect the ventricles from too fast rhythm, thus creating a functional AV block 2:1 (possibly 3:1, 4:1).Ītrial flutter can transform into atrial fibrillation and vice versa. The ventricular frequency is usually half of the normal (150/min). atrial flutter waves of sawtooth character (resembling sawtooth), especially in leads II, III, aVL and V1.regular atrial activity at a rate of 250-350/min (in atrial fibrillation, the atrial activity is irregular).Reentry in atypical flutter occurs heterogeneously, in both right and left atria, independent of the cavotricuspid isthmus.ĭiagnosis is based on ECG. clockwise atrial flutter ( clockwise flutter) Ītypical atrial flutter (type II) 2:1 lock-in is a typical form of MS failure in patients with atrial flutter and the mechanism is closely linked to the typical atrial sensing windows.Typical atrial flutter is a regular tachyarrhythmia with a large reentry circuit in the right atrium, part of which passes through the cavotricuspid isthmus.Ītrial #flutter circling counterclockwise ( counterclockwise flutter) Possible causes: The same as for atrial fibrillation.Typical atrial flutter (type I) NOTE: Atrial flutter may presents with variable AV conduction, particularly after receiving cardiac medications. NOTE: Atrial flutter with 1:1 conduction and wide QRS is rare but often mistaken for ventricular tachycardia. NOTE: Atrial flutter can be typical or atypical depending on whether the cavotricuspid isthmus (CTI) participates or not in the reentrant circuit. NOTE: The most common AV ratio is 2:1, resulting in a ventricular rate of ~150 bpm. NOTE: Atrial flutter is probably the most overlooked arrhythmia. NOTE: Odd ratios (1:1, 3:1, 5:1) are really uncommon. Note the negative fluter waves (F waves) with AV conduction ratio of 2:1 and ventricular rate of ~150 bpm. Same rhythm strip with graphical explanation. “F” waves with “sawtooth” appearance, best seen in inferior leads and V1.Atrial rate usually 300/min (usual range 250-350 bpm).It is characterized by regular atrial activity with “ sawtooth” appearance. It results from organized electrical activity in which large areas of the atrium take part in the reentrant circuit. Atrial flutter is an arrhythmia resulting from reentry in a macroreentrant circuit, most commonly in the right atrium. Typical atrial flutter (counterclockwise cavotricuspid isthmus-dependent atrial flutter) is a macroreentrant atrial tachycardia with atrial rates usually above 250 bpm up to 320 bpm.
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