Atrial Flutter Questions & Answers

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

Overview

What is atrial flutter (AFL)?

What signs and symptoms of atrial flutter (AFL)?

What are less common symptoms of atrial flutter (AFL)?

Which physical findings are characteristic of atrial flutter (AFL)?

What is included in the physical exam for suspected atrial flutter (AFL)?

What are possible complications of atrial flutter (AFL)?

Which tests are performed in the workup of atrial flutter (AFL)?

What is the role of transthoracic echocardiography (TTE) in the diagnosis of atrial flutter (AFL)?

What are the treatment options for symptomatic atrial flutter (AFL)?

What is atrial flutter (AFL) and how is it characterized?

How do typical (or classic) and atypical atrial flutter (AFL) differ?

Which cardiac disorders are most frequently associated with atrial flutter (AFL)?

What are the symptoms of atrial flutter (AFL)?

What is the role of ventricular response rate control in the management of atrial flutter (AFL)?

How is atrial flutter (AFL) similar to atrial fibrillation (AF)?

What is the pathogenesis of typical atrial flutter (AFL)?

What is the role of an anatomic or functional block in the pathogenesis of atrial flutter (AFL) in animal models?

What is the role of crista terminalis in the pathogenesis of atrial flutter (AFL)?

What is the pathophysiology of typical counterclockwise atrial flutter (AFL)?

What is the pathophysiology of typical clockwise atrial flutter (AFL)?

What is the pathophysiology of atypical atrial flutter (AFL)?

Which cardiac disorders are associated with atrial flutter (AFL)?

Which medical conditions are associated with atrial flutter (AFL)?

What causes atrial flutter (AFL) following open heart surgery?

What are the genetic causes of atrial flutter (AFL)?

What is the prevalence of atrial flutter (AFL) in the US?

How does the prevalence of atrial flutter (AFL) vary by sex?

How does the incidence of atrial flutter (AFL) vary by age?

What is the prognosis of atrial flutter (AFL)?

What causes morbidity and mortality in atrial flutter (AFL)?

What is the life expectancy for patients with atrial flutter (AFL)?

What is the prognosis of typical atrial flutter (AFL)?

What are the major complications rates for catheter ablation procedures to treat atrial flutter (AFL)?

What causes conversion of atrial fibrillation (AF) to atrial flutter (AFL)?

What is the prognosis of atrial flutter (AFL) following emergency department (ED) treatment?

What causes left atrial appendage thrombus (LAAT) in atrial flutter (AFL)?

What is the included in the patient education Information for atrial flutter (AFL)?

Presentation

What are common symptoms of atrial flutter (AFL)?

What are less common symptoms of atrial flutter (AFL)?

What should be the focus of history in the evaluation of atrial flutter (AFL)?

What is the importance of the onset of symptoms in the evaluation of atrial flutter (AFL)?

What does preexcitation syndrome in the history of a patient with atrial flutter (AFL) suggest?

What is commonly present in the history of a patient with concurrent atrial flutter (AFL) and atrial fibrillation (AF)?

What is the role of general appearance and vital signs in the evaluation of atrial flutter (AFL)?

What should be included in the initial physical exam for suspected atrial flutter (AFL)?

Which cardiac findings are characteristic of atrial flutter (AFL)?

What elements should be included in the physical exam for atrial flutter (AFL)?

What are complications of atrial flutter (AFL)?

DDX

How is atrial fibrillation (AF) differentiated from atrial flutter (AFL)?

How should electrocardiogram (ECG) findings be reviewed in the evaluation of atrial flutter (AFL)?

What are the differential diagnoses for Atrial Flutter?

Workup

How is atrial flutter (AFL) diagnosed?

What is the role of the history and physical exam in the workup of atrial flutter (AFL)?

What is the role of a CBC count in the diagnosis of atrial flutter (AFL)?

What is the role of chest radiography in the diagnosis of atrial flutter (AFL)?

Which electrocardiogram (ECG) results are characteristic of atrial flutter (AFL)?

What is the role of atrial rate in the diagnosis of atrial flutter (AFL)?

What is the role of ventricular rate in the diagnosis of atrial flutter (AFL)?

What is the role of wave morphology in the diagnosis of atrial flutter (AFL)?

What is the role of vagal maneuvers in the diagnosis of atrial flutter (AFL)?

What is the role of exercise testing in the diagnosis of atrial flutter (AFL)?

What is the role of transthoracic echocardiography (TTE) in the diagnosis of atrial flutter (AFL)?

Treatment

What are the treatment goals for symptomatic atrial flutter (AFL)?

What is the main difference between atrial fibrillation (AF) and atrial flutter (AFL)?

What is the first-line therapy in the treatment of atrial flutter (AFL)?

What is the role of radiofrequency ablation (RFA) in the treatment of atrial flutter (AFL)?

When is cardioversion indicated in the treatment of atrial flutter (AFL)?

When should anticoagulation therapy be administered in the treatment of atrial flutter (AFL)?

When are rate- and rhythm-control strategies indicated in the treatment of atrial flutter (AFL)?

Which medications slow atrioventricular (AV) node conduction in atrial flutter (AFL)?

What is the role of anticoagulation therapy in the treatment of atrial flutter (AFL)?

What is the role of therapeutic international normalized ratio (INR) in the treatment of atrial flutter (AFL)?

What are the treatment options for atrial flutter (AFL) in patients needing cardiac surgery?

What is the role of ventricular rate control in the treatment of atrial flutter (AFL)?

What is the success rate of electrical conversion for the treatment of atrial flutter (AFL)?

What are the treatments options for atrial flutter (AFL) when cardioversion is unsuccessful?

What technique is used to perform cardioversion for the treatment of atrial flutter (AFL)?

How should electrodes be positioned in cardioversion for the treatment of atrial flutter (AFL)?

How does the efficacy of anterior-posterior electrode positioning compare to anterior-lateral positioning for cardioversion of atrial flutter (AFL)?

What is the role of dofetilide in the treatment of atrial flutter (AFL)?

What is the role of ibutilide in the treatment of atrial flutter (AFL)?

What is the role of IC antiarrhythmic agents in the treatment of atrial flutter (AFL)?

How is the risk for thromboembolic complications of atrial flutter reduced?

What is the similarities and differences between atrial fibrillation and atrial flutter (AFL) on TEE?

What is the prevalence of thrombotic events in atrial flutter (AFL)?

What is the risk of stroke in atrial flutter (AFL)?

What is the CHA2DS2-VASc score and how is it used in atrial flutter (AFL)?

How frequently do postcardioversion thromboembolic events complicate atrial flutter (AFL)?

How is postcardioversion stunning managed in atrial flutter (AFL)?

When is anticoagulation therapy indicated in patients receiving catheter ablation for atrial flutter (AFL)?

How is catheter ablation used to treat atypical atrial flutter (AFL)?

What is the role of radiofrequency ablation (RFA) in the treatment of atrial flutter (AFL)?

What are the benefits of catheter ablation for the treatment of atrial flutter (AFL)?

What are the limitations of radiofrequency ablation (RFA) for the treatment of atrial flutter (AFL)?

How is catheter ablation performed in patients with typical atrial flutter (AFL)?

What is the role of a line of conduction block during radiofrequency ablation (RFA) for atrial flutter radiofrequency ablation (RFA)?

What is the recurrence rate for atrial flutter (AFL) following radiofrequency ablation (RFA)?

What is the efficacy of radiofrequency ablation (RFA) for the treatment of atypical atrial flutter (AFL)?

What is the role of ultra-high density-activation sequence mapping (UHD-ASM) in the ablation of atypical atrial flutter (AFL)?

How is atrial flutter (AFL) managed after the initial episode is terminated?

Which treatments should be considered prior to antiarrhythmic drug therapy for atrial flutter (AFL)?

What is the efficacy of antiarrhythmic agents in the treatment of atrial flutter (AFL)?

How should antiarrhythmic agents be selected for the treatment of atrial flutter (AFL)?

What is the role of amiodarone in the treatment of atrial flutter (AFL)?

Guidelines

Which organizations have released treatment guidelines for atrial flutter (AFL)?

What are the newest guidelines for the management of supraventricular tachycardia?

What are the ESC/AEPC guidelines for the management of supraventricular tachycardia?

What are the ACC/AHA/HRS recommendations for rate control in acute atrial flutter (AFL)?

What are the ACC/AHA/HRS recommendations for rhythm control in acute atrial flutter (AFL)?

What are the ACC/AHA/HRS recommendations for rate control in ongoing atrial flutter (AFL)?

What are the ACC/AHA/HRS recommendations for rhythm control in ongoing atrial flutter (AFL)?

What are the ACC/AHA/HRS recommendations for use of antiarrhythmic agents in the treatment of ongoing atrial flutter (AFL)?

What are the thrombosis prevention guidelines for atrial flutter (AFL)?

What is the ACCP recommended anticoagulation therapy for patients with atrial flutter (AFL) at risk of stroke?

What are the ACCP recommended oral anticoagulants for atrial flutter (AFL)?

What are the ACCP anticoagulation recommendations for persistent atrial flutter (AFL)?

What are the ACCP recommendations for use of long-term anticoagulation therapy in atrial flutter (AFL)?

What is the ACCP recommended anticoagulation therapy for patients with atrial flutter (AFL) at intermediate risk of stroke?

Medications

When are medications administered for the treatment of atrial flutter (AFL)?

When are mediations indicated for the outpatient treatment of atrial flutter (AFL)?

Which medications are indicated for inpatient care of atrial flutter (AFL)?

Which medications in the drug class Antidysrhythmics, Class IC are used in the treatment of Atrial Flutter?

Which medications in the drug class Antidysrhythmics, Class III are used in the treatment of Atrial Flutter?

Which medications in the drug class Antidysrhythmics, Class IV are used in the treatment of Atrial Flutter?

Which medications in the drug class Antidysrhythmics, Class V are used in the treatment of Atrial Flutter?

Which medications in the drug class Anticoagulants, Cardiovascular are used in the treatment of Atrial Flutter?

Which medications in the drug class Beta-Blockers, Beta-1 Selective are used in the treatment of Atrial Flutter?