FLUTTER EKG Paroxysmal macro reentry circuit Presence of abnormal conduction within atria as well as AV node conduction block Sawtooth P waves Typical CCW 90 Lead II Lead II and aVF show negative sawtooth P waves ID: 909392
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Slide1
Atrial Flutter
Jazmine
Boloor
Slide2FLUTTER: EKG
Paroxysmal, macro reentry circuit
Presence of abnormal conduction within atria, as well as AV node conduction block
Sawtooth P wavesTypical CCW (90%): Lead II, Lead II, and aVF show negative sawtooth P waves Atypical Flutter: any other flutter (can be positive sawtooth)
Slide3TYPICAL FLUTTER: EMG
Several negative sawtooth P waves associated with each QRS wave
Concentric activation from CS 10 to 1
Slide4ATYPICAL FLUTTER: EMG
Several positive sawtooth P waves associated with each QRS wave
CS is showing stacked signals– not concentric
Left atrial flutter around mitral valve
Slide5DIAGNOSIS
If a patient is in normal sinus rhythm, burst pace to induce tachycardia
Extra stims may be used
This patient is diagnosed with typical flutter.Reentry circuit within the right atrium Showing negative sawtooth waves
Slide6ABLATION
Target: burn a line of block from the IVC to the tricuspid valve.
Alternatively, for atypical flutter, the patient would have to be put into arrythmia (burst pacing) and mapped to find where flutter is coming from. Then, a line of block can be burned.
Two nonconducting structures Successful ablation will result in normal sinus rhythm that does not induce tachycardia
Slide7Thank you!