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    K - 7 Atrial Flutter (IKA)

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    thomasfelix
    This document summarizes atrial flutter and atrial fibrillation. Atrial flutter is characterized by a sawtooth atrial rate of around 300 beats per minute and varying ventricular response rates, and is caused by structural heart issues or previous surgery. Management includes digitalis to slow the ventricular rate along with beta blockers or amiodarone. Electric cardioversion or pacing may be needed, and anticoagulation is recommended before cardioversion. Atrial fibrillation has a very fast irregular atrial rate of 350-600 beats per minute and irregular ventricular response. It is associated with structural heart disease and digitalis toxicity. Management focuses on rate control with digitalis and beta blockers as well as pharmacological or electric cardio

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    K - 7 Atrial Flutter (IKA)

    Uploaded by

    thomasfelix
    112 views8 pages
    This document summarizes atrial flutter and atrial fibrillation. Atrial flutter is characterized by a sawtooth atrial rate of around 300 beats per minute and varying ventricular response rates, and is caused by structural heart issues or previous surgery. Management includes digitalis to slow the ventricular rate along with beta blockers or amiodarone. Electric cardioversion or pacing may be needed, and anticoagulation is recommended before cardioversion. Atrial fibrillation has a very fast irregular atrial rate of 350-600 beats per minute and irregular ventricular response. It is associated with structural heart disease and digitalis toxicity. Management focuses on rate control with digitalis and beta blockers as well as pharmacological or electric cardio

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    atrial flutter

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    This document summarizes atrial flutter and atrial fibrillation. Atrial flutter is characterized by a sawtooth atrial rate of around 300 beats per minute and varying ventricular response rates, and is caused by structural heart issues or previous surgery. Management includes digitalis to slow the ventricular rate along with beta blockers or amiodarone. Electric cardioversion or pacing may be needed, and anticoagulation is recommended before cardioversion. Atrial fibrillation has a very fast irregular atrial rate of 350-600 beats per minute and irregular ventricular response. It is associated with structural heart disease and digitalis toxicity. Management focuses on rate control with digitalis and beta blockers as well as pharmacological or electric cardio

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    112 views8 pages

    K - 7 Atrial Flutter (IKA)

    Uploaded by

    thomasfelix
    This document summarizes atrial flutter and atrial fibrillation. Atrial flutter is characterized by a sawtooth atrial rate of around 300 beats per minute and varying ventricular response rates, and is caused by structural heart issues or previous surgery. Management includes digitalis to slow the ventricular rate along with beta blockers or amiodarone. Electric cardioversion or pacing may be needed, and anticoagulation is recommended before cardioversion. Atrial fibrillation has a very fast irregular atrial rate of 350-600 beats per minute and irregular ventricular response. It is associated with structural heart disease and digitalis toxicity. Management focuses on rate control with digitalis and beta blockers as well as pharmacological or electric cardio

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 8

    ATRIAL FLUTTER

    &
    ATRIAL FIBRILLATION

    MUHAMMAD ALI
    PEDIATRIC CARDIOLOGY DIVISION
    ATRIAL FLUTTER
    Description
    • The pacemaker lies in an ectopic focus, and “circus
    movement” in the atrium is the mechanism of this
    arrhythmia. Atrial flutter is characterized by an atrial rate
    (F wave with “sawtooth” configuration) of about 300
    beats/minute, a ventricular response with varying
    degrees of block (e.g., 2:1, 3:1, 4:1), and normal QRS
    complexes
    Causes

    • Possible causes are structural heart disease with dilated


    atria, myocarditis, previous surgery involving atria (the
    Mustard or Senning procedure, Fontan operation, or
    atrial septal defect repair), and digitalis toxicity

    Significance
    • The ventricular rate determines eventual cardiac output;
    a too-rapid ventricular rate may decrease cardiac output.
    Atrial flutter usually suggests a significant cardiac
    pathology.
    Management

    • Digitalization is provided if the arrhythmia is not the result of digitalis


    toxicity; digitalis increases the AV block and thereby slows the
    ventricular rate. Propranolol (1 to 4 mg/kg per day orally in three or
    four doses) may be added to digoxin

    • Recent reports suggest that amiodarone may be more effective than


    digoxin in treating atrial flutter. One can start with a trial of digoxin
    and, if digoxin fails, progress to amiodarone

    • Electric cardioversion may be required. Digitalis should be


    discontinued for at least 48 hours before cardioversion.
    Anticoagulation with warfarin is recommended before cardioversion
    to prevent embolization

    • Rapid atrial pacing with a catheter in the esophagus or the right


    atrium can be effective when cardioversion is contraindicated (e.g.,
    digitalized patients)

    • Quinidine may prevent recurrence.


    ATRIAL FIBRILLATION
    Description
    • The mechanism of this arrhythmia is “circus movement,”
    as in atrial flutter. Atrial fibrillation is characterized by an
    extremely fast atrial rate (f wave at a rate of 350 to 600
    beats/minute) and an irregularly irregular ventricular
    response with normal QRS complexes
    Causes

    • Atrial fibrillation usually is associated with structural heart


    disease, including dilated atria; myocarditis; digitalis
    toxicity; or previous intra-atrial surgery

    Significance

    • The rapid ventricular rate, in addition to the loss of


    coordinated contraction of the atria and ventricles,
    decreases the cardiac output, as occurs in atrial
    tachycardia.
    • Atrial fibrillation usually suggests a significant cardiac
    pathology.
    Management

    • AF > 48 hours, anticoagulation warfarin for 3 weeks to prevent


    systemic embolization of atrial thrombus. Anticoagulation is continued
    for 4 weeks after the restoration of sinus rhythm. If cardioversion
    cannot be delayed, heparin should be started, with subsequent oral
    anticoagulation

    • Digoxin is provided to slow the ventricular rate. Propranolol (1 to 4


    mg/kg per day orally in three or four doses) may be added

    • As a pharmacologic means of conversion, class I antiarrhythmic


    agents (e.g., quinidine, procainamide, flecainide) and the class III
    agent amiodarone may be used

    • In patients with chronic atrial fibrillation, anticoagulation with warfarin


    should be considered to reduce the incidence of thromboembolism

    • Quinidine may prevent recurrence.


    THANK YOU

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