Atrial Flutter

Atrial flutter occurs when there's a re-entrant circuit in the right atrium where the electrical signal cycles at 300bpm w/o interruption. Due to the fast atrial rate, the AVN causes a ‘block’ so that some of the atrial activity isn't conducted to the ventricles. This is a physiological response of the AVN to allow time for ventricular filling. This therefore creates a degree of heart block meaning that only 2:1, 3:1, 4:1, or 5:1 atrial impulses is conducted to the ventricles.

This therefore leads to its characteristic sawtooth appearance on an ECG.

It's causes are similar to that of AF, but it's more likely to occur with lung diseases such as COPD, PE, Pulmonary HTN.

It presents very similarly to AF. Palpitations, dizziness, chest pain.

Management is the same as AF i.e. same  rate/rhythm control options.

N.B. The distinction between AF and Flutter in the acute setting is academic, therefore it doesn’t matter if you're unsure which one it is as they’d be treated the same way!