The 12 Rhythms of Christmas: Atrial Flutter

This article is the third in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It is a continuation of the theme behind last year’s 12 Leads of Christmas. This is a new edit of the first article I ever published on my personal blog, so it may seem familiar to some readers. Finally, if you were curious about the mystery rhythm in Fig. 16 of the first post on sinus tachycardia, you might be surprised to know that it shows atrial flutter with 2:1 conduction. The same tracing pops up in Fig. 23 of this article. Atrial Flutter Have you slammed adenosine to cure a patient’s SVT with a fluorish? Figure 1. Pre-adenosine. *PUSH* – *FLUSH* – “You’re gonna feel funny.” Figure 2. A few seconds after the adenosine push. …only to see the saw-tooth waves of atrial flutter marching across the monitor? While you may have performed a successful diagnostic test, your unsuspecting patient has just been given a sneak peek of the day their heart quits beating with no relief from the arrhythmia actually causing their symptoms. Figure 3. s/p adenosine. Well, you need-not make that mistake again, because I’ve put together a rough list of (almost) every tip out there for diagnosing subtle atrial-flutter with 2:1 conduction. In the end you’ll be talented enough to recognize this arrhythmia with your monitor upside-down (hint)! Electrophysiology There’s three things you need to understand about the physiology of atrial ...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: 12 Rhythms of Christmas Vince DiGiulio Source Type: research