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Tachycardia: Difference between revisions
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===Atrial Flutter=== | ===Atrial Flutter=== | ||
====Pathophysiology:==== | ====Pathophysiology:==== | ||
Atrial flutter (AFT) is the most common type of atrial tachycardia. The typical atrial flutter is dependent of the cavotricuspid isthmus.<cite>Saoudi</cite> The isthmus between the caval vein and tricuspid is an area of slow conduction. Due to this slow conduction counterclockwise re-entry around the tricuspid annulus can exist. This re-entry produces a typical arrhythmia with activates the atria at a frequency between 250-350 beats per minute. If the re-entry circuit moves counterclockwise a typical AFT is produced. If the re-entry circuit moves clockwise, a atypical AFT is seen. The causes and risk are comparable with atrial fibrillation. | Atrial flutter (AFT) is the most common type of atrial tachycardia. The typical atrial flutter is dependent of the cavotricuspid isthmus.<cite>Saoudi</cite> The isthmus between the caval vein and tricuspid is an area of slow conduction. Due to this slow conduction counterclockwise re-entry around the tricuspid annulus can exist. This re-entry produces a typical arrhythmia with activates the atria at a frequency between 250-350 beats per minute. If the re-entry circuit moves counterclockwise a typical AFT is produced. If the re-entry circuit moves clockwise, a atypical AFT is seen.<cite>Yang</cite> The causes and risk are comparable with atrial fibrillation. | ||
====Clinical diagnosis:==== | ====Clinical diagnosis:==== | ||
An AFT is usually paroxysmal, with a sudden onset, and is diagnosed on the ECG by it typical sawtooth pattern and atrial frequency. Patients experience complaints of palpitations, dyspneu, fatigue or chest pain. An AFT has a frequency of 300 bpm, which conducts to the ventricles in 2:1, 3:1 or 4:1 manner. The P-wave morphology has a sawtooth like appearance and in a typical AFT has a negative vector in the inferior leads. The first part of the P-wave is fast, the second path slow. In a atypical AFT the inferior leads have a positive vector. Atrial fibrillation is a common finding in patients with an atrial flutter (up to 35%). | An AFT is usually paroxysmal, with a sudden onset, and is diagnosed on the ECG by it typical sawtooth pattern and atrial frequency. Patients experience complaints of palpitations, dyspneu, fatigue or chest pain. An AFT has a frequency of 300 bpm, which conducts to the ventricles in 2:1, 3:1 or 4:1 manner. The P-wave morphology has a sawtooth like appearance and in a typical AFT has a negative vector in the inferior leads. The first part of the P-wave is fast, the second path slow. In a atypical AFT the inferior leads have a positive vector. Atrial fibrillation is a common finding in patients with an atrial flutter (up to 35%). | ||