How do you read an atrial flutter on an ECG?
How do you read an atrial flutter on an ECG?
ECG features of atrial flutter
- Narrow complex tachycardia.
- Regular atrial activity at ~300 bpm.
- Loss of the isoelectric baseline.
- “Saw-tooth” pattern of inverted flutter waves in leads II, III, aVF.
- Upright flutter waves in V1 that may resemble P waves.
- Ventricular rate depends on AV conduction ratio (see below)
What is a typical atrial flutter?
Typical atrial flutter is an organised atrial tachycardia. It can also be defined as a macroreentrant tachycardia confined to the right atrium. This arrhythmia has a 200-260 ms cycle length, although it may fluctuate depending on patient’s previous treatment or ablation, congenital heart disease, etc.
What is the hallmark characteristic of atrial flutter?
The hallmark of AF is the irregularly irregular ventricular response. Atrial flutter is a supraventricular arrhythmia typically seen in patients with underlying heart disease. The rotational movement of the reentry circuit causes the hallmark sawtooth waves that are classic for atrial flutter.
What is type 1 and type 2 atrial flutter?
Atrial flutter (AFl) is a cardiac dysrhythmia characterized by rapid and regular depolarization of the atria that appears as a sawtooth pattern on the electrocardiogram (ECG) and is categorized into type I (typical) and type II (atypical) AFl.1 The ECG in type I (typical) AFl is characterized by an inverted sawtooth …
How can you tell the difference between atrial flutter and atrial fibrillation?
Normally, the top chambers (atria) contract and push blood into the bottom chambers (ventricles). In atrial fibrillation, the atria beat irregularly. In atrial flutter, the atria beat regularly, but faster than usual and more often than the ventricles, so you may have four atrial beats to every one ventricular beat.
What is the difference between typical and atypical flutter?
The term atypical has been applied to rapid atrial tachycardias with ECG patterns differing from the typical and reverse typical flutter described above, and also to re-entrant tachycardias with circuit configuration different from the typical RA flutter circuit, even if they have an ECG pattern similar to typical …
What is the rate of atrial flutter rhythm?
The atrial rate during atrial flutter is between 250 and 350 bpm. At this rate, the AV node is usually refractory long enough to block at least every other beat from conducting to the ventricles. The class IC antiarrhythmic drugs can slow the atrial rate and increase AV nodal conduction as well.
What is a 2 1 flutter?
Download a copy of the guide: 10 tips to identify atrial flutter. When atrial flutter is conducted 2:1, the resulting ventricular rate is around 125-175 per minute (usually around 150). This is because the P waves (flutter waves) in atrial flutter occur at about 250-350 per minute (usually around 300).
What is the standard range for atrial rate?
Normal range at rest is between 60-100 beats per minute (bpm). to go by RR or PP interval. If it is 1 big box (0.2 secs) then the rate is 60/0.2 = 300 bpm. The rest of the sequence would be as follows.
Does aflutter have P waves?
This is because the P waves (flutter waves) in atrial flutter occur at about 250-350 per minute (usually around 300). At this rate, it can appear that there is a P wave in front of each QRS and a T wave after each QRS.
What does clockwise atrial flutter mean on an ECG?
Atrial Flutter ECG Review. At times, the direction of the circuit can reverse, causing clockwise atrial flutter from the same anatomical location. This appears as positively-directed flutter waves in the inferior leads. Atypical atrial flutter originates from the left atrium or areas in the right atrium, such as surgical scars,…
What ECG leads are best for flutter waves?
The flutter waves (on the contrary to f-waves in atrial fibrillation) have identical morphology (in each ECG lead). Flutter waves are typically best seen in leads II, III aVF, V1, V2 and V3.
How is atrial flutter (AFL) distinguished on the electrocardiogram?
Atrial flutter is distinguishable on the electrocardiogram because it is a rhythmic tachycardia with heart rates that are divisors of 300 bpm, 150 bpm being the most frequent in untreated patients (AV conduction ratio 2:1). There are no existing P waves, although atrial waves with “saw-tooth” pattern are spotted with rates around 300 bpm.
What does Sawtooth flutter mean on ECG?
Atrial Flutter ECG Review. This produces a characteristic “ sawtooth ” pattern of the P waves — different from atrial fibrillation, in which the atrial rate is so fast that the P waves are not identifiable, or only coarse fibrillatory waves are seen.
