Atrial Flutter Differential Diagnoses

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Diagnostic Considerations

Coarse atrial fibrillation may mimic atrial flutter over limited electrocardiogram (ECG) strips. Prolonged recordings will uncover an irregular rate and variation in P wave morphology (as compared to a regular rate and P wave morphology with atrial flutter). The distinction between atrial flutter and atrial tachycardia is generally arbitrarily based on the atrial rate, and does not mechanistically distinguish these rhythms.

The ECG should be reviewed for the following:

  • Artifact from tremor
  • Atrial tachycardia with atrioventricular block
  • Atrial tachycardia, multifocal
  • Narrow-complex tachyarrhythmias
  • Wide-complex tachyarrhythmias

Differential Diagnoses