Page 104 - Critical Care Notes
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4223_Tab02_045-106 29/08/14 10:00 AM Page 98
CV ■ ■ ■ ■ ■ ■ ■ 4:1 → 4 flutter waves: 1 QRS); loss of atrial kick. Seen in coronary artery disease and valvular disease. Flutter waves
treat OSA.
QRS: Normal or narrow.
Atrial rate: 250–400 bpm.
PR interval: Unable to determine.
P waves: Saw-toothed flutter waves.
Ventricular rate: Slow or fast depending on degree of block.
Rhythm: Regular or irregular depending if combination of degrees of block (e.g., 2:1 + 4:1).
atenolol, pindolol, , digoxin, amiodarone, electrical cardioversion if ventricular rate >150 bpm, radiofre-
Management: Diltiazem; propafenone (rhythmol), flecainide (tambocor), acebutolol, esmolol, metoprolol,
quency ablation; anticoagulate. Consider Tikosyn (dofetilide) if refractory to cardioversion. Assess for and
AV node conducts impulses to the ventricle with varying degrees of block (2:1 →2 flutter waves:1 QRS;
98 Atrial Flutter
