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Tachycardia: Difference between revisions
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→Atrial arrhythmias
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===Atrial Flutter=== | ===Atrial Flutter=== | ||
====Pathophysiology:==== | |||
Atrial flutter is a type of atrial tachycardia that is dependent of the cavotricuspid isthmus. The isthmus between the caval vein and tricuspid is an area of slow conduction. Due to this slow conduction re-entry around the tricuspid annulus can exist. This re-entry produces a typical arrhythmia with activates the atria at a certain frequency. If the re-entry circuit moves counterclockwise a typical atrial flutter is produced. If the re-entry circuit moves clockwise, a atypical flutter is seen. The causes and risk are comparable with atrial fibrillation. | |||
====Clinical diagnosis:==== | |||
An atrial flutter can be detected on the ECG by it typical sawtooth pattern and atrial frequency. An atrial flutter 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 flutter has a negative vecter in the inferior leads. The first part of the P-wave is fast, the second path slow. In a atypical flutter the inferior leads have a positive vector. | |||
====Management:==== | |||
A patient with an atrial flutter requires cardioversion. This can be achieved with anti-arrhythmic drugs or electrical cardioversion. Patients with atrial flutter require anti-coagulation as in atrial fibrillation according to the CHADSVASc score. Atrial flutters are amendable to catheter ablation. This is a very succesfull procedure, with few complications in the hands of an experiences electrophysiologist. | |||
===Atrial Fibrillation=== | ===Atrial Fibrillation=== | ||
The most interesting arrhythmia of all! | |||
==AV node arrhythmias== | ==AV node arrhythmias== | ||