Introduction
Pathophysiology
Usually results from a large reentrant circuit involving the cavotricuspid isthmus of the right atrium
Clinical manifestations
- Risk factors
- Similar to those for atrial fibrillation
- Coronary artery disease, hypertension, and heart failure.
Holiday heart syndrome
???? ??? ??? Afib? ? ??! (?? ??)
Common atrial flutter
Macroreentrant
Treatment
Afib? ???? version 50~100J? ??
- Carries a similar risk of arterial thromboembolism to atrial fibrillation
? patient with multiple CHA2DS2-VASc risk factors should be started on chronic anticoagulation (eg, rivaroxaban, apixaban) therapy. - Rate control
Interventions
Increase the risk of a thromboembolic event and should be preceded by several weeks of anticoagulation therapy.
Radiofrequency ablation
Definitive treatment.
Electric cardioversion
Multifocal atrial tachycardia
Multifocal atrial tachycardia. Rhythm strip obtained from a patient with severe pulmonary disease during an acute illness. Arrows note three distinct P-wave morphologies.
Etiology
- Exacerbation of pulmonary disease (eg, COPD)
- Electrolyte disturbance (eg, hypokalemia)
- Catecholamine surge (eg, sepsis)
Clinical findings
- Typically asymptomatic
- Rapid, irregular pulse
- ECG: ?3 P-wave forms & atrial rate >100/min
Treatment
- Correct underlying disturbance
- AV nodal blockade (eg, verapamil) if persistent.
Leave a Reply