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    Atrial Flutter Dan Atrial Fibrilasi: Hauda El Rasyid

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    Fifi Fathira
    This document discusses atrial flutter and atrial fibrillation. It defines them as types of supraventricular tachycardia and describes their mechanisms, symptoms, diagnosis and treatment options. Atrial flutter is characterized by a sawtooth pattern on ECG with regular atrial and ventricular rates between 250-350 bpm. Radiofrequency ablation targeting the isthmus area is an effective treatment for atrial flutter, abolishing it in 85% of cases. Atrial fibrillation is an irregular heart rhythm that increases risk of stroke and heart failure. Guidelines recommend rate or rhythm control strategies as well as anticoagulation to prevent thromboembolism depending on patient risk factors. Catheter ablation can cure atrial

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    Atrial Flutter Dan Atrial Fibrilasi: Hauda El Rasyid

    Uploaded by

    Fifi Fathira
    15 views44 pages
    This document discusses atrial flutter and atrial fibrillation. It defines them as types of supraventricular tachycardia and describes their mechanisms, symptoms, diagnosis and treatment options. Atrial flutter is characterized by a sawtooth pattern on ECG with regular atrial and ventricular rates between 250-350 bpm. Radiofrequency ablation targeting the isthmus area is an effective treatment for atrial flutter, abolishing it in 85% of cases. Atrial fibrillation is an irregular heart rhythm that increases risk of stroke and heart failure. Guidelines recommend rate or rhythm control strategies as well as anticoagulation to prevent thromboembolism depending on patient risk factors. Catheter ablation can cure atrial

    Original Description:

    kardiovaskular

    Original Title

    2.5.5.2 Afl Dan Af

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    This document discusses atrial flutter and atrial fibrillation. It defines them as types of supraventricular tachycardia and describes their mechanisms, symptoms, diagnosis and treatment options. Atrial flutter is characterized by a sawtooth pattern on ECG with regular atrial and ventricular rates between 250-350 bpm. Radiofrequency ablation targeting the isthmus area is an effective treatment for atrial flutter, abolishing it in 85% of cases. Atrial fibrillation is an irregular heart rhythm that increases risk of stroke and heart failure. Guidelines recommend rate or rhythm control strategies as well as anticoagulation to prevent thromboembolism depending on patient risk factors. Catheter ablation can cure atrial

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    15 views44 pages

    Atrial Flutter Dan Atrial Fibrilasi: Hauda El Rasyid

    Uploaded by

    Fifi Fathira
    This document discusses atrial flutter and atrial fibrillation. It defines them as types of supraventricular tachycardia and describes their mechanisms, symptoms, diagnosis and treatment options. Atrial flutter is characterized by a sawtooth pattern on ECG with regular atrial and ventricular rates between 250-350 bpm. Radiofrequency ablation targeting the isthmus area is an effective treatment for atrial flutter, abolishing it in 85% of cases. Atrial fibrillation is an irregular heart rhythm that increases risk of stroke and heart failure. Guidelines recommend rate or rhythm control strategies as well as anticoagulation to prevent thromboembolism depending on patient risk factors. Catheter ablation can cure atrial

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 44

    Atrial flutter dan Atrial Fibrilasi

    Hauda el rasyid

    Divisi aritmia
    Bagian kardiologi dan kedokteran vaskular
    FK UNAND/RSUP DR. M. Djamil Padang

    1
    Mekanisme aritmia

    2
    Supra ventricular arrhitmia
     Supra Ventricular Tachycardia /SVT :

    AVNRT : AV nodal reentrant tachycardia

    AVRT : AV reciprocating tachycardia

    AT : atrial tachycardia

    JT : junctional tachycardia
     Atrial flutter /AFL

     atrial fibrillation /AF


    3
    Antoni Bayés de Luna. CLINICAL ARRHYTHMOLOGY. Hoboken,2011
    4
    Antoni Bayés de Luna. CLINICAL 5
    Antoni Bayés de Luna. CLINICAL
    ARRHYTHMOLOGY. Hoboken,2011 6
    Atrial Flutter

    • sawtooth appearance /F waves or flutter waves


    Atrial rhythm and ventricular response regular /
    irregular
    Atrial rate 250-350 beats/min
    Ventricular rate varies depending on the number
    of impulses the AV node is blocking
    No P waves or PR interval
    QRS normal width or with aberrancy 7
    8
    9
    Diagram of AFL Circuit Within Right Atrium

    Inferior vena cava -


    Cosio FG. Am J Cardiol. 1993;71:705-709. tricuspid valve isthmus
    11
    12
    13
    14
    15
    16
    17
    18
    19
    20
    SVT symptoms
    No symptomps
    Palpitation
    Lightheadedness
    Dizziness
    shortness of breath
    reduced exercise capacity
    weakness, fatigue
    chest discomfort, sweating

    21
    therapy
    • Acute :

    unstable haemodynamic

    synhronise cardioversion

    informed concern

    sedation

    Synch cardioversion 50-100 Joule

     Stable haemodynamic : Anti arrhythmia drugs


    22
    therapy
    • Chronic :

    Sama dengan AF management

    AAD : efektifitas hanya 45%, Efek samping banyak

    RFA : terutama untuk typical AFL , memuaskan

    23
    RF Ablation of Atrial Flutter

    • a macro-reentry circuit within the right atrium.

    • Critical areas of conduction within the right atrium are


    necessary to sustain atrial flutter.

    • RF ablation of conduction within such critical sites (most


    commonly the inferior vena cava-tricuspid valve isthmus)
    abolishes atrial flutter in 85% of cases.

    Cosio FG. Am J Cardiol. 1993;71:705-709.


    25
    Atrial fibrillation, AF

    26
    27
    28
    Clinical Events (Outcomes) Affected by AF

    Camm AJ, et al. Guidelines for the management of atrial fibrillation. The Task Force for the Management of Atrial
    Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010; 31(19):2369–2429
    30
    2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: 31
    Executive Summary JACC VOL. 64, NO. 21, 2014
    2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation:
    Executive Summary JACC VOL. 64, NO. 21, 2014
    32
    33
    34
    35
    36
    37
    Who should be referred?
    • Symptomatic patients
    – AVNRT (>90% succes rates)
    – WPW and symptomatic AVRT (CCB ; BB and Dig not
    appropriate as sole therapy) (>90%)
    – Aflutter(>90%)
    – AFib (40-70%)
    • High risk for sudden death
    – AFib with WPW and cycle length <250 ms
    • Not amenable to catheter ablation
    – MAT
    – Reversible causes (thryotoxicosis; PE; post-op)

    39
    SVT AVNRT
    DIAGNOSIS
    • SYMPTOMS
    • ECG, HOLTER,ILR

    40
    SVT AVNRT

    41
    42
    43
    44

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