From the Guidelines
Atrial flutter, commonly referred to as "flutter," is a type of supraventricular arrhythmia characterized by a rapid, regular atrial rhythm, typically between 250-350 bpm, with a distinctive "sawtooth" pattern on electrocardiogram (ECG) in the inferior leads. When referring to "Rachel flutter," it is likely that the question is asking about atrial flutter, a recognized medical condition.
Key Characteristics of Atrial Flutter
- Atrial rate: 250-350 bpm
- Ventricular response: typically 2:1 or 4:1 AV block, resulting in a ventricular rate of 150 bpm or 75 bpm, respectively
- ECG pattern: "sawtooth" waves in the inferior leads, with a positive P wave in lead V1 for counterclockwise CTI-dependent flutter
Clinical Presentation
Patients with atrial flutter may present with symptoms such as palpitations, dyspnea, fatigue, or chest pain, as noted in the 2003 ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias 1.
Diagnosis and Treatment
Atrial flutter can be diagnosed using ECG and may be treated with antiarrhythmic medications, cardioversion, or catheter ablation, as discussed in the 2016 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia 1. Some key points to consider when evaluating and managing atrial flutter include:
- The risk of thromboembolism, which is thought to be similar to that of atrial fibrillation
- The potential for atrial flutter to coexist with or be triggered by atrial fibrillation
- The importance of considering underlying cardiac disease or other conditions that may contribute to the development of atrial flutter.
From the Research
Atrial Flutter Description
- Atrial flutter, also known as Rachel flutter, is a type of supraventricular tachycardia characterized by a rapid but regular atrial rhythm 2.
- The condition is often associated with atrial fibrillation, and the treatment approaches for both conditions share some similarities 3, 4.
ECG Characteristics
- On an electrocardiogram (ECG), atrial flutter is typically recognized by a sawtooth or flutter wave pattern, with a regular atrial rate usually between 250-350 beats per minute 2.
- The ventricular rate, however, can vary depending on the degree of atrioventricular (AV) block, which determines how many of the atrial impulses are conducted to the ventricles 2.
Treatment Approaches
- Treatment for atrial flutter often involves rate control or rhythm control strategies, using medications such as beta-blockers, calcium channel blockers, or antiarrhythmic drugs like flecainide or propafenone 3, 5, 6.
- In some cases, electrical cardioversion may be necessary to restore a normal sinus rhythm, especially in patients who are hemodynamically unstable or have not responded to other treatments 4, 2.