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Atrial flutter (AFL) is a common abnormal heart rhythm that starts in the atrial chambers of the heart. [1] When it first occurs, it is usually associated with a fast heart rate and is classified as a type of supraventricular tachycardia. [2]
The normal firing rate from the SA node is 60-100 beats per minute. But in atrial flutter the electrical signals are coming from a reentrant circuit which moves much faster, let’s say 350 beats per minute. In this case, there are no normal P-waves. Instead they are called flutter waves, or F waves, and they take on this sawtooth shape.
Paroxysmal atrial tachycardia has a regular rate, however a high rate of about 140-250 bpm, p waves are generally hidden and the PR interval is not measurable. Atrial flutter has an atrial rate of 250-400 and can be identified by p waves with saw tooth deflections.
"A normal heart rate is 60 to 100 beats a minute when you’re at rest," reads the Cleveland Clinic website. "Atrial flutter can make your heart’s upper chambers beat 250 to 350 times a minute ...
A "saw tooth" pattern with QRS complexes is the hallmark of atrial flutter. A sine wave pattern is the hallmark of ventricular flutter. Absent P waves with wide QRS complexes and a fast heart rate are ventricular tachycardia. Determination of rate and rhythm is necessary in order to make sense of further interpretation.
A Holter monitor is a wearable ambulatory heart monitor that continuously monitors the heart rate and heart rhythm for a short duration, typically 24 hours. In individuals with symptoms of significant shortness of breath with exertion or palpitations regularly, a Holter monitor may be of benefit to determine whether rapid heart rates (or ...
"Abnormal heart rhythms such as Atrial Fibrillation, Supraventricular Tachycardia, Ventricular Fibrillation or Ventricular Tachycardia can also cause palpitations," Dr. Serwer explains. This ...
If the baseline has a totally irregular form, this suggests fibrillatory waves of atrial fibrillation or possibly artefact; a saw tooth shaped baseline suggests the flutter waves of atrial flutter. With either of these rhythms, if the ventricular rate is fast, the fibrillatory or flutter waves can easily be misinterpreted as P waves.