Atrial flutter

What is it?

The heart contracts thanks to specialised cellular structures that generate electrical impulses and regulate their distribution within the heart.

Under normal circumstances the electrical impulse originates in the sinoatrial node, travels through the atria and reaches the atrioventricular node, which is the only pathway for electrical communication between the atria and ventricles; from here the impulse travels to the bundle of His and the intraventricular conduction system.

This is an atrial tachycardia associated with the presence of a large re-entry circuit in the right atrium. This circuit allows the same electrical impulse to travel clockwise or anti-clockwise several times in the right atrium.

The anatomical obstacles creating the circuit are the tricuspid valve at the front, crista terminalis of the inferior vena cava and the eustachian valve at the back.

Which are the symptoms?

The circuit results in an atrial contraction rate of 300 BPM. Fortunately, the atrioventricular node does not conduct all these impulses to the ventricles, but only 1 in 2, 1 in 3 or more, preventing the heart from beating at a life-threatening rate.

A 1:1 conduction is rare, in which case atrial flutter poses an immediate danger to the patient.

Such tachycardia may be paroxysmal (episodes of varying duration intermittent with periods of normal rhythm) or continuous.

How is it diagnosed?

Suggested exams

How is it treated?

Transcatheter ablation using fluoroscopic or (in unrepresentative cases) non-fluoroscopic techniques is the treatment of choice.

Are you interested in receiving the treatment?

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