cardiovascular disorders
Atrial Flutter
Treatment of Atrial Flutter
Rate control with medication Rhythm control with cardioversion, medication, or ablation Prevention of thromboembolism Treatment of atrial flutter focuses on ventricular rate control, rhythm control, and prevention of thromboembolism. Pharmacologic rate control is more difficult to achieve in atrial flutter than in atrial fibrillation. Thus, for most patients, electrical conversion (using Cardiac Resynchronization Therapy (CRT) or overdrive pacing) is the treatment of choice for an initial episode and is mandatory with 1:1 AV conduction or hemodynamic compromise. Typically, low-energy (50 joules) conversion is effective. ). Many of the Medications for Arrhythmias that can restore sinus rhythm (especially class Ia and Ic) can slow atrial flutter, shorten AV nodal refractoriness (by their vagolytic effects), or do both enough to allow 1:1 conduction with paradoxical increase in ventricular rate and hemodynamic compromise. These medications may be used for long-term maintenance as required to prevent recurrence. An antitachycardia pacing system is an alternative to long-term use of antiarrhythmics and is a rare therapy used in patients with an independent indication for pacing who are ineligible or in whom other approaches to rhythm control have failed. Also, Ablation for Cardiac Arrhythmia designed to interrupt the atrial reentrant circuit may effectively prevent atrial flutter, particularly typical atrial flutter. inhibitor). The choice among the therapies is based on the same considerations as in the Treatment . 