Content
- What is atrial flutter?
- Symptoms
- Causes
- Heart rate
- When can we talk about rhythm disturbance?
- ECG diagnostics
- Electrocardiographic signs of TP
- Transcribing Research Answers
- Urgent care
- When is radiofrequency catheter ablation needed?
- Drug treatment for hemodynamic instability
- Treatment for stable hemodynamic TP
- Prognosis and complications
- Atrial Flutter Videos
Atrial flutter is a specific type of atrial fibrillation. In most cases, the pathological condition manifests itself in seizures. Men over 60 are under attack. The diagnosis and treatment is carried out by a cardiologist. The specialist will prescribe an examination and identify pathological changes on the ECG. Taking into account the results obtained, he will select an effective treatment for the patient.
What is atrial flutter?
Atrial flutter is an abnormal heart rhythm when the number of contractions increases over 300 beats. A distinctive feature of the pathology is the persisting sinus rhythm. Pathological processes often occur against the background of another disease in the human body.
Symptoms
Atrial flutter (on an ECG examination, a cardiologist will see characteristic changes in the heart contractions) is accompanied by a nonspecific clinical picture in order to determine the nature of pathological processes.
However, seizures disrupt a person's health and cause the following symptoms:
- the heart rhythm is disturbed (the patient feels sharp blows, frequent heartbeats and skipping contractions);
- pain syndrome (there is a slight discomfort in the chest area of a pressing and burning character);
- tachycardia develops (cardiac activity accelerates, which is characterized by a mark of up to 110-120 beats per minute);
- a person has shortness of breath (a sudden symptom that appears at rest at an early stage in the development of pathological processes);
- there is an insignificant decrease in blood pressure;
- worried about headache, vertigo is present, orientation in space is disturbed;
- general weakness, drowsiness occurs, and physical activity of a person decreases.
The symptomatology of atrial flutter increases in the case of mixed pathological processes. More pronounced symptoms occur in acute coronary insufficiency. Painful sensations help stop analgesics, but medications should be taken as prescribed by your doctor.
Shortness of breath in a person is manifested by attacks, but as the disease progresses, it becomes permanent and always accompanies the patient. In some situations, the clinical symptoms of pathological processes are completely absent. They appear as the ventricles are affected.
Causes
In most cases, it is the pathological processes that provoke the appearance of atrial flutter:
- infectious diseases due to which the myocardium becomes inflamed;
- ischemic heart disease, after which scars or sclerosed areas remain on the tissues of the heart muscle;
- dystrophic changes, against the background of which the myocardium suffers;
- chronic pulmonary pathologies;
- hypertension affecting the functioning of the left ventricle.
Surgical treatment for the heart can lead to the development of atrial flutter.
In addition to the main reasons, it is also important to highlight the provoking factors that trigger pathological processes:
- old age after 60 years;
- male gender;
- bad habits (smoking, drugs and alcohol abuse);
- increased production of thyroid hormones;
- potassium deficiency;
- prolonged stress, emotional outbursts and strong experiences.
Atrial flutter also provoke vigorous physical activity, high ambient temperature. The ECG will help to clarify the parameters.
Heart rate
Heart rate indicators are influenced by numerous factors, including a person's age, environment, gender, external and internal reasons. Depending on the age in medicine, certain norms of heart stroke are established:
Age (years) | Minimum / maximum allowable parameters | Average heart rate |
Babies | 110/170 | 140 |
1 | 102/162 | 132 |
1-2 | 94/154 | 124 |
4-6 | 86/126 | 106 |
6-8 | 78/118 | 98 |
8-10 | 68/108 | 88 |
10-12 | 60/100 | 80 |
12-15 | 55/95 | 75 |
15-50 | 60/80 | 70 |
50-60 | 64/84 | 74 |
60-80 | 69/89 | 79 |
Indicators during the day constantly deviate slightly, depending on various circumstances. You should panic if violations are constantly present and at the same time give a person serious discomfort, are also accompanied by accompanying symptoms.
When can we talk about rhythm disturbance?
When measuring heart rate, it is important to take into account not only the heart rate, but also their rhythm. The work of the heart should continue without pause or interruption. Consultation of a cardiologist is required for a person if the heart rate is irregular. The same applies to slow (<50 beats per minute) or quickened (> 100 beats per minute) contractions. Disorders also include seizures when the heart rate exceeds 140 beats per minute.
ECG diagnostics
Patients with suspected atrial flutter are primarily assigned an electrocardiogram (ECG). Additionally, a comprehensive examination is carried out to identify concomitant diseases and other changes in the human body:
Name | Description |
Ultrasound examination (ultrasound) | The specialist examines the heart, assesses the condition of its tissues and structure. Reveals pathological processes. |
Blood analysis | An analysis of hormones is performed to assess the functioning of the thyroid and pancreas, the rheumatoid factor and the level of potassium in the patient's body are determined. |
Echocardiography (EchoCG) | The diagnostic method will help determine the direction of pulse circulation and identify thrombotic neoplasms. |
Comprehensive diagnostics will help not only differentiate the disease, but also choose the most effective treatment. Atrial flutter is manifested by symptoms that are similar to other pathologies (nodal and atrial tachycardia, atrial fibrillation).
Electrocardiographic signs of TP
Atrial flutter on the ECG is accompanied by gross and serious changes. Given the course of pathological processes, the electrocardiogram will show the following changes:
Name | Symptoms |
Typical flutter |
|
Atypical flutter |
|
In some situations, patients develop atrial flutter with complete AB block. In this case, the ventricular rate slows down to 35-45 beats per minute. There are no coincidences with the phases of the F waves. The pathological condition in medicine is called Frederick's syndrome.
Transcribing Research Answers
The cardiologist conducts diagnostics and deciphers the results of the pathological condition. In some situations, the patient may need to consult other specialized doctors (neurologist, endocrinologist, therapist).
Urgent care
First aid to the patient is provided in the inpatient department of the hospital or at home. An attack with atrial flutter can be removed on its own if the pathology develops at an early stage, when there are no degenerative changes. If there are concomitant diseases, the patient needs emergency hospitalization and medical assistance. In this case, it is almost impossible to stop the attack on your own.
The algorithm of actions for providing emergency care is as follows:
- Call a doctor.
- Measure blood pressure and heart rate of the patient.
- Open the window to let in fresh air.
- It is not recommended to take medications only if there is a prescription from the attending physician.
- The person must be placed in a reclining position, while putting a roller under his back from any available means.
- It is necessary to perform rhythmic breathing, for each movement for 5 seconds.
- Calm down. If the patient is in a panic and is scared, it is necessary to give the person valerian tincture or sedatives, but without alcohol.
Before the arrival of an ambulance, the patient is advised to adhere to complete rest, not move or make sudden movements. First aid will not help get rid of the disease, hospitalization is necessarily shown to a person. It is important not to give it up in order to undergo therapy and prevent complications.
When is radiofrequency catheter ablation needed?
Atrial flutter on an ECG of the first type in the case of counterclockwise pulse circulation requires catheter ablation. The effectiveness of a medical procedure in most cases is 95%.
The procedure is prescribed to patients in case of detection of one or more arrhythmic foci, against the background of which atrial flutter appears. The treatment is carried out by an electrophysiologist. Radiofrequency catheter ablation destroys cells that interfere with the normal functioning of the heart.
During medical procedures, thin long tubes (catheters) are directed to the patient's heart through the blood vessels. When they reach the pathological focus, heat or cold is supplied, after which the cells are destroyed.
Drug treatment for hemodynamic instability
Atrial flutter requires a properly selected complex therapy, the main purpose of which is to prevent blood clots, control of heartbeats, restoration of normal rhythm and elimination of concomitant symptoms.
Patients are prescribed special drugs, which are important to take strictly according to the instructions or prescriptions of the attending physician:
Drug group | Name | Application |
Anticoagulants | Warfarin, Heparin | Medicines thin the blood and prevent blood clots. The dosage of the drug is selected in each case individually. On average, the patient is prescribed 5 mg per day. The course of treatment lasts 6-12 months. |
Beta blockers | Esmolol, Propranolol | The drugs control your heart rate. The drug is administered intravenously at 500 mcg / kg for 1 min, then at 50 mcg / kg in 4 minutes. The maintenance dosage is 25 μg / kg per minute. |
Calcium channel blockers | Verapamil, Diltiazem | The tablets are recommended to be swallowed whole, not chewed and washed down with a sufficient amount of water. The dosage of the drug in each case is selected individually and ranges from 40 to 120 mg 3 times a day. The minimum course of therapy is 7 days. In difficult situations, the medicine is administered intravenously. |
Antiarrhythmic drugs | Amiodarone, Sotalol | The drugs restore the normal heart rate. The tablets should be taken before meals, not chewed, swallowed whole and washed down with water. The initial dosage of the drug is 600-800 mg 3 times a day. The course of treatment depends on the patient's condition and lasts 5-14 days. |
Cardiac glycosides | Digoxin, Celanide | The medicine is swallowed whole, washed down with water, taken between meals. The adult dosage is 0.5-1 mg once. Then the medicine must be taken every 6 hours at 0.25-0.75 mg for 2-3 days. |
Medicines are used for the efficient functioning of the ventricles, which are responsible for cardiac output. Additionally, patients are prescribed potassium preparations to replenish the deficiency of the necessary element.
Treatment for stable hemodynamic TP
Atrial flutter on an ECG examination helps to eliminate special procedures that restore a normal heart rhythm. In the absence of a positive result after drug therapy or in emergency situations, patients are shown surgical treatment.
Name | Description |
Electrical cardioversion | During the procedure, a high-energy pulsed electrical discharge is used, with the help of which a normal heart rhythm is restored. |
Installing a pacemaker | A pacemaker will help maintain a normal heartbeat and rhythm in the event of sick sinus syndrome. This is a small electronic device. It is surgically inserted into the patient's chest. The main task of a pacemaker is to generate an electrical impulse to restore the normal pace of the heartbeat. |
AV node ablation | Treatment involves the delivery of radio frequency energy between the upper and lower chambers of the heart. It targets the atrioventricular junction to destroy a small number of cells. As a result, irregular impulses appear that enter the stomachs and provoke atrial fibrillation. Additionally, an electrical pacemaker is installed to maintain a normal heart rate. |
Surgical operation "Labyrinth" | Surgery involves making tiny incisions in the upper chambers of your heart. They heal over time, and in their place is scar tissue that does not conduct electrical impulses. Symptoms of atrial flutter decrease as these impulses break. |
After surgery, the patient may be prescribed medications to help prevent a recurrence of atrial flutter. Additionally, patients are advised to radically change their lifestyle, eat right, give up bad habits, and avoid stressful situations.
Prognosis and complications
Complications against the background of atrial flutter more often occur in patients if there are concomitant diseases of the cardiovascular system.
The negative consequences include the following pathological conditions:
- ventricular fibrillation;
- the formation of a blood clot in the pulmonary artery;
- the development of a stroke;
- impaired renal function;
- arrhythmogenic cardiomyopathy;
- heart failure.
Any complication can end badly for the patient, up to and including death. Despite the seriousness of the situation, in 80% of cases the forecasts are favorable. Timely diagnosed pathology is successfully treated.
Patients diagnosed with atrial flutter on an ECG should always be under the supervision of a cardiologist arrhythmologist. Prevention of attacks will help the prevention of diseases, against the background of which pathological processes develop. To do this, it is enough to adhere to the simple rules of the attending physician.
Atrial Flutter Videos
Atrial flutter: