officesoli.blogg.se - Atrial flutter atrial fibrillation

The ventricular response may be regular or irregular.This includes other supraventricular tachyarrhythmias such as: Heart failure, hypotension and respiratory distress may be present.May be associated with signs of underlying causes - eg, thyrotoxicosis, alcoholism, pericarditis, valvular dysfunction or septal heart defects.Atrial flutter waves may be present in the jugular venous pulse.Carotid massage may decrease the ventricular rate. 1:1 atrioventricular (AV) conduction may lead to haemodynamic collapse. Arteriovenous conduction is usually 2:1, making the ventricular rate approximately 150 bpm. Pulse may be irregular or regular, but is usually rapid.Thromboembolism with transient ischaemic attacks or stroke.Mild symptoms include palpitations, irregular heartbeat, fatigue, dyspnoea, chest pain, dizziness.May present with ECG findings of atrial flutter.Initial presentation varies from a coincidental ECG finding to being in extremis with heart failure or embolic stroke. It may be asymptomatic but can present in a variety of ways. Other studies in the literature seem to relate to atrial fibrillation but a later meta-analysis found a 12% increased risk associated with NSAID use. One study found use of non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) - particularly new use - has been found to be associated with a 40-70% increased relative risk of developing atrial flutter or fibrillation.

Thyrotoxicosis, phaeochromocytoma, electrolyte imbalance.

Sick sinus syndrome, cardiac conduction pre-excitation syndromes - eg, Wolff-Parkinson-White syndrome.

Cardiac surgery and ablation procedures.

Atrial dilation due to septal defects, pulmonary emboli, mitral or tricuspid valve dysfunction or chronic ventricular failure.

This explains many of the associations below. Structural abnormalities are also a strong risk factor, with left atrial dilatation possibly one of the strongest predicting factors for the likely development of atrial flutter. There is no difference if there is associated atrial fibrillation.Īge is the most important risk factor.

Systemic embolism is less common than it is in atrial fibrillation (occurring about 30% as frequently).

Atrial flutter is more common in men, with males accounting for 80% of cases.

With an ageing population, it is becoming increasingly common. Around 50% of those presenting with atrial flutter alone are said to develop atrial fibrillation within the next eight years.

Atrial flutter is commonly associated with atrial fibrillation.

It is the second most common arrhythmia after atrial fibrillation.

It is one tenth as common as atrial fibrillation.

Atrial flutter is less common than atrial fibrillation, but epidemiology is less well studied.

ECG patterns are variable and there may be faster atrial rates than in typical flutter. This is also called non-cavotricuspid isthmus-dependent atrial flutter.

In atypical atrial flutter, the origin is elsewhere in the right atrium or the left atrium.

The ECG pattern shows regular mainly negative atrial deflections in the inferior leads with a 'saw-tooth pattern' at rates of 240-350 bpm per minute. This is also called cavotricuspid isthmus (CTI) or common atrial flutter.

In typical atrial flutter the rhythm has its origin in the right atrium at the level of the tricuspid valve.

Like atrial fibrillation, it can be paroxysmal or persistent. Atrial flutter is a macro-reentrant tachycardia and can be classed as typical or atypical atrial flutter depending upon the origin. There is typically an atrial rate of around 300 beats per minute (bpm) and a ventricular rate that may be fixed or be variable.

Pathophysiology Ītrial flutter is characterised by an abnormal and rapid heart rhythm.

See also the separate Atrial Fibrillation article. Both arrhythmias can cause clinical symptoms such as palpitations, syncope and fatigue, and are associated with a risk of thrombus formation and thromboembolism. European and American guidelines cover the conditions separately although there, much of the management is the same. There are many similarities in clinical presentation and management, and indeed the guideline from the National Institute for Health and Care Excellence (NICE) makes hardly a distinction, stating the guideline for atrial fibrillation applies to patients with atrial flutter, specifying a particular management in the latter only in one sentence. Many patients with atrial flutter have associated atrial fibrillation. Atrial flutter is one of the more common atrial arrhythmias (supraventricular arrhythmias).