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Atrial flutter
Background
Overview
Definition
Atrial flutter is a supraventricular arrhythmia characterized by rapid, regular atrial contractions, primarily confined to the right atrium.
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Pathophysiology
The pathophysiology of atrial flutter involves the formation of a reentrant circuit, often around the tricuspid valve or along the RA wall. This circuit results in a rapid and regular atrial rhythm. Abnormal intraatrial conduction, slow conduction paths, and areas of low voltage in the atria can contribute to the initiation and maintenance of these reentrant circuits.
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Epidemiology
The prevalence of idiopathic neonatal atrial flutter in Europe is estimated at 1.5 per 100,000 population.
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Risk factors
Risk factors for atrial flutter include advancing age (particularly prevalent in the elderly population) and underlying cardiac conditions such as hypertension, HF, and congenital heart disease. Additional risk factors include pulmonary disease, hyperthyroidism, and the use of specific medications, such as class 1C antiarrhythmic drugs.
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Disease course
The clinical features of atrial flutter often include palpitations, dyspnea, and chest discomfort. However, the diagnosis is often confirmed through a 12-lead ECG or an electrophysiology study and mapping. Complications can include stroke, HF, thromboembolism, and progression to AF.
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Prognosis and risk of recurrence
The prognosis of atrial flutter can be influenced by several factors. The presence of underlying heart disease can complicate the condition and lead to poorer outcomes. There is a risk of progression to AF.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of atrial flutter are prepared by our editorial team based on guidelines from the American Academy of Family Physicians (AAFP 2024), the American Heart Association (AHA/HRS/ACC/ACCP 2024), the European Society of Cardiology (ESC/EACTS 2024,2021), the Canadian Cardiovascular Society (CCS/CHRS 2020), the European Society of Cardiology (ESC 2020,2018), the Canadian Cardiovascular Society ...
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