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atrial flutter


Def....atrial flutter is characterised by a regular rapid atrial rate of 250-350/min.where ventricles respond to every second,third or fourth heart beat (2:1,3:1 atrioventricular block).

Causes
-Organic heart disease (ischaemic,rheumatic,congenital).
-pericarditis
-acute respiratory failure
-1st week following open heart surgery.
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Electrocardiographic feature
-characteristic flutter waves r seen as regular saw toothed waves F waves.

Management
-immediate conversion to sinus rhythm can be accomplished by direct current cardioversion or atrial pacing
-initial reduction of ventricular rate using digoxin.beta blockers or verapamil followed by conversion to sinus rhythm using quinidine.amiodarone.disopyramide.
-prevention of recurrences can be accomplished by quinidine.amiodarone.disopyramide or flecainide.

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