Atrial flutter

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Classification according to ICD-10
I48.3 Atrial flutter: typical
atrial flutter, type I.
I48.4 Atrial flutter: atypical
atrial flutter, type II
I48.9 Atrial fibrillation and atrial flutter: unspecified
ICD-10 online (WHO version 2019)
Video describes the mechanism of atrial flutter. English with German subtitles.

Atrial flutter , a form of absolute arrhythmia , is a temporary ( paroxysmal = seizure) or permanent ( permanent ) cardiac arrhythmia in which the atria of the heart are regularly excited 240 to 340 times per minute at rest, while the ventricles usually beat more slowly.

Excerpt from a long-term ECG of nocturnal paroxysmal atrial flutter
Left: Atrial flutter
Middle: Sinus node arrest with pre-automatic pause for approx. 2.7 seconds
Right: Onset of sinus rhythm

Atrial flutter can lead to a " racing heart " in the form of regular pulse acceleration ( tachycardia ) to 120 to 170 beats per minute, because the AV node typically only transfers every second excitation of the atria to the ventricles (2: 1 transfer). With disturbed excitation line and under the influence of AV nodal blocking drugs (. Eg, verapamil , amiodarone , beta-blockers or digitalis ) increases the blocking ratio (eg 3:. 1 or 4: 1 or irregular), so that the Heart chambers beat more slowly and possibly irregularly.

Heart diseases such as myocarditis, coronary sclerosis, mitral valve defects and thyrotoxic myopathy caused by hyperthyroidism (thyrotoxicosis) are possible causes of the atrial flutter .

With regard to diagnosis and therapy , atrial flutter differs only slightly from the more common atrial fibrillation .

Individual evidence

  1. ^ Herbert Reindell , Helmut Klepzig: Diseases of the heart and the vessels. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin / Göttingen / Heidelberg 1955; 2nd edition ibid 1961, pp. 450-598, here: pp. 567 f. ( Atrial flutter ).
  2. ^ Herbert Reindell, Helmut Klepzig: Diseases of the heart and the vessels. 1961, p. 568.