Atrial flutter overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Atrial flutter is an abnormal heart rhythm that occurs in the atria of the heart. When it first occurs, it is usually associated with a fast heart rate or tachycardia, and falls into the category of supra-ventricular tachycardias. While this rhythm occurs most often in individuals with cardiovascular disease (eg: hypertension, coronary artery disease, and cardiomyopathy), it may occur spontaneously in people with otherwise normal hearts. It is typically not a stable rhythm, and frequently degenerates into atrial fibrillation. However, it does rarely persist for months to years.
Classification
There are two types of atrial flutter, the common type I and rarer type II. Most individuals with atrial flutter will manifest only one of these. Rarely someone may manifest both types; however, they can only manifest one type at a time.
Pathophysiology
Atrial flutter is a form of cardiac arrhythmia characterized by an atrial rate ranging from 240 to 400 beats per minute. It is the most common atrial tachycardia after atrial fibrillation, with a uniform and regular continuous wave-form.[1] It is caused by a reentrant rhythm in either the right or left atrium. Some degree of atrio-ventricular block is usually associated with atrial flutter. Similar to atrial fibrillation the rate of ventricular beating depends on the degree of conduction through the atrio-ventricular node. Usual scenario is 2:1 or 4:1 conduction but occasionally there can exist a 1:1 conduction.