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Atrial flutter

Unstable

Stable

❑ Look for the presence of any of these: ❑ Chronic heart failure ❑ Hypotension ❑ Acute myocardial infarction

❑ Administer anticoagulation therapy based on the risk of stroke, if total duration of flutter > 48 hours ❑ Administer rate control therapy (AV nodal blockers) THEN ❑ Attempt conversion ❑ DC cardioversion ❑ Atrial pacing ❑ Pharmacological cardioversion

❑ Assess need for therapy to prevent recurrence

❑ Administer antiarrythmic therapy to prevent recurrences ❑ Consider catheter ablation if antiarrhythmic therapy fails