A report on Atrial flutter

Atrial flutter with varying A-V conduction (5:1 and 4:1)
Type I atrial flutter, counterclockwise rotation with 3:1 and 4:1 AV nodal block.
Atrial flutter with a two to one block. Note the P waves hiding in the T waves in leads V1 and V2

Common abnormal heart rhythm that starts in the atrial chambers of the heart.

- Atrial flutter
Atrial flutter with varying A-V conduction (5:1 and 4:1)

21 related topics with Alpha

Overall
Leads aVL and aVF of an electrocardiogram showing atrial fibrillation. There are irregular intervals between heart beats. No P waves are seen and there is an erratic baseline between QRS complexes. The heart rate is about 125 beats per minute.

Atrial fibrillation

16 links

Abnormal heart rhythm (arrhythmia) characterized by rapid and irregular beating of the atrial chambers of the heart.

Abnormal heart rhythm (arrhythmia) characterized by rapid and irregular beating of the atrial chambers of the heart.

Leads aVL and aVF of an electrocardiogram showing atrial fibrillation. There are irregular intervals between heart beats. No P waves are seen and there is an erratic baseline between QRS complexes. The heart rate is about 125 beats per minute.
Normal rhythm tracing (top) Atrial fibrillation (bottom)
How a stroke can occur during atrial fibrillation
Non-modifiable risk factors (top left box) and modifiable risk factors (bottom left box) for atrial fibrillation. The main outcomes of atrial fibrillation are in the right box. BMI=Body Mass Index.
A 12-lead ECG showing atrial fibrillation at approximately 132 beats per minute
Diagram of normal sinus rhythm as seen on ECG. In atrial fibrillation the P waves, which represent depolarization of the top of the heart, are absent.
ECG of atrial fibrillation (top) and normal sinus rhythm (bottom). The purple arrow indicates a P wave, which is lost in atrial fibrillation.
3D Medical Animation still shot of Left Atrial Appendage Occlusion

It may also start as other forms of arrhythmia such as atrial flutter that then transform into AF.

Ventricular fibrillation (VF) showing disorganized electrical activity producing a spiked tracing on an electrocardiogram (ECG)

Arrhythmia

11 links

Too fast or too slow.

Too fast or too slow.

Ventricular fibrillation (VF) showing disorganized electrical activity producing a spiked tracing on an electrocardiogram (ECG)
Broad classification of arrhythmias according to region of heart required to sustain the rhythm
Normal sinus rhythm, with solid black arrows pointing to normal P waves representative of normal sinus node function, followed by a pause in sinus node activity (resulting in a transient loss of heartbeats). Note that the P wave that disrupts the pause (indicated by the dashed arrow) does not look like the previous (normal) P waves – this last P wave is arising from a different part of the atrium, representing an escape rhythm.

Supraventricular tachycardias include atrial fibrillation, atrial flutter and paroxysmal supraventricular tachycardia.

Lead II electrocardiogram strip showing PSVT with a heart rate of about 180.

Supraventricular tachycardia

7 links

Umbrella term for fast heart rhythms arising from the upper part of the heart.

Umbrella term for fast heart rhythms arising from the upper part of the heart.

Lead II electrocardiogram strip showing PSVT with a heart rate of about 180.
Mechanisms of supraventricular tachycardias
Holter monitor-Imaging with start (red arrow) and end (blue arrow) of a SV-tachycardia with a pulse frequency of about 128/min.
A 12-lead ECG showing paroxysmal supraventricular tachycardia at about 180 beats per minute.
Atrial fibrillation: Red dots show atrial fibrillation activity.
Impulse arising in SA node, traversing atria to AV node, then entering ventricle. Rhythm originating at or above AV node constitutes SVT.
Atrial fibrillation: Irregular impulses reaching AV node, only some being transmitted.

There are four main types of SVT: atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), and Wolff–Parkinson–White syndrome.

ECG of a heart in normal sinus rhythm

Electrocardiography

9 links

Process of producing an electrocardiogram , a recording of the heart's electrical activity.

Process of producing an electrocardiogram , a recording of the heart's electrical activity.

ECG of a heart in normal sinus rhythm
Normal 12-lead ECG
A 12-lead ECG of a 26-year-old male with an incomplete right bundle branch block (RBBB)
A patient undergoing an ECG
An EKG electrode
Proper placement of the limb electrodes. The limb electrodes can be far down on the limbs or close to the hips/shoulders as long as they are placed symmetrically.
Placement of the precordial electrodes
The limb leads and augmented limb leads (Wilson's central terminal is used as the negative pole for the latter in this representation)
300px
Diagram showing the contiguous leads in the same color in the standard 12-lead layout
QRS is upright in a lead when its axis is aligned with that lead's vector
Schematic representation of a normal ECG
Measuring time and voltage with ECG graph paper
Animation of a normal ECG wave
Formation of limb waveforms during a pulse
An early commercial ECG device (1911)
ECG from 1957
Use of real time monitoring of the heart in an intensive care unit in a German hospital (2015), the monitoring screen above the patient displaying an electrocardiogram and various values of parameters of the heart like heart rate and blood pressure
A 12-lead ECG of a 26-year-old male with an incomplete right bundle branch block (RBBB)

An esophageal lead avails for a more accurate differentiation between certain cardiac arrhythmias, particularly atrial flutter, AV nodal reentrant tachycardia and orthodromic atrioventricular reentrant tachycardia.

Heart

8 links

Muscular organ in most animals.

Muscular organ in most animals.

Human heart during an autopsy
Computer-generated animation of a beating human heart
The human heart is in the middle of the thorax, with its apex pointing to the left.
Heart being dissected showing right and left ventricles, from above
Frontal section showing papillary muscles attached to the tricuspid valve on the right and to the mitral valve on the left via chordae tendineae.
Layers of the heart wall, including visceral and parietal pericardium
The swirling pattern of myocardium helps the heart pump effectively
Arterial supply to the heart (red), with other areas labelled (blue).
Autonomic innervation of the heart
Development of the human heart during the first eight weeks (top) and the formation of the heart chambers (bottom). In this figure, the blue and red colors represent blood inflow and outflow (not venous and arterial blood). Initially, all venous blood flows from the tail/atria to the ventricles/head, a very different pattern from that of an adult.
Blood flow through the valves
The cardiac cycle as correlated to the ECG
The x-axis reflects time with a recording of the heart sounds. The y-axis represents pressure.
Transmission of a cardiac action potential through the heart's conduction system
Conduction system of the heart
The prepotential is due to a slow influx of sodium ions until the threshold is reached followed by a rapid depolarization and repolarization. The prepotential accounts for the membrane reaching threshold and initiates the spontaneous depolarization and contraction of the cell; there is no resting potential.
3D echocardiogram showing the mitral valve (right), tricuspid and mitral valves (top left) and aortic valve (top right). The closure of the heart valves causes the heart sounds.
Cardiac cycle shown against ECG
Heart and its blood vessels, by Leonardo da Vinci, 15th century
Animated heart
Elize Ryd making a heart sign at a concert in 2018
The tube-like heart (green) of the mosquito Anopheles gambiae extends horizontally across the body, interlinked with the diamond-shaped wing muscles (also green) and surrounded by pericardial cells (red). Blue depicts cell nuclei.
Basic arthropod body structure – heart shown in red
The human heart viewed from the front
The human heart viewed from behind
The coronary circulation
The human heart viewed from the front and from behind
Frontal section of the human heart
An anatomical specimen of the heart
Heart illustration with circulatory system
Animated Heart 3d Model Rendered in Computer

These arrhythmias can take many forms and can originate from different structures within the heart—some arise from the atria (e.g. atrial flutter), some from the atrioventricular node (e.g. AV nodal re-entrant tachycardia) whilst others arise from the ventricles (e.g. ventricular tachycardia).

ECG showing sinus tachycardia with a rate of about 100 beats per minute

Tachycardia

6 links

Heart rate that exceeds the normal resting rate.

Heart rate that exceeds the normal resting rate.

ECG showing sinus tachycardia with a rate of about 100 beats per minute
12 lead electrocardiogram showing a ventricular tachycardia (VT)

Atrial flutter

Artistic impression of a woman experiencing syncope, which may be accompanied by heart palpitations

Palpitations

6 links

Further characterized by the hard, fast and/or irregular beatings of the heart.

Further characterized by the hard, fast and/or irregular beatings of the heart.

Artistic impression of a woman experiencing syncope, which may be accompanied by heart palpitations

The cardiac etiologies of palpitations are the most life-threatening and include ventricular sources (premature ventricular contractions (PVC), ventricular tachycardia and ventricular fibrillation), atrial sources (atrial fibrillation, atrial flutter) high output states (anemia, AV fistula, Paget's disease of bone or pregnancy), structural abnormalities (congenital heart disease, cardiomegaly, aortic aneurysm, or acute left ventricular failure), and miscellaneous sources (postural orthostatic tachycardia syndrome abbreviated as POTS, Brugada syndrome, and sinus tachycardia).

Conduction through the accessory pathway results in a delta wave.

Wolff–Parkinson–White syndrome

10 links

Disorder due to a specific type of problem with the electrical system of the heart.

Disorder due to a specific type of problem with the electrical system of the heart.

Conduction through the accessory pathway results in a delta wave.
Graphic representation of the electrical conduction system of the human heart
Transmission of a cardiac action potential through the conduction system of the normal human heart
Graphic representation of the bundle of Kent in Wolff–Parkinson–White syndrome
One beat from a rhythm strip in V2 demonstrating characteristic findings in Wolff–Parkinson–White syndrome. A characteristic delta wave (above the blue bar), a short PR interval (red bar) of 80 ms, and a long QRS complex (blue bar plus green bar) at 120 ms are visible.
12 lead electrocardiogram of an individual with Wolff–Parkinson–White syndrome

In situations where the atria generate excessively rapid electrical activity (such as atrial fibrillation or atrial flutter), the AV node limits the number of signals conducted to the ventricles.

Caffeine's principal mode of action is as an antagonist of adenosine receptors in the brain.

Adenosine

3 links

Organic compound that occurs widely in nature in the form of diverse derivatives.

Organic compound that occurs widely in nature in the form of diverse derivatives.

Caffeine's principal mode of action is as an antagonist of adenosine receptors in the brain.

Fast rhythms of the heart that are confined to the atria (e.g., atrial fibrillation, atrial flutter) or ventricles (e.g., monomorphic ventricular tachycardia) and do not involve the AV node as part of the re-entrant circuit are not typically converted by adenosine.

Catheter ablation

4 links

Catheter ablation is a procedure used to remove or terminate a faulty electrical pathway from sections of the heart of those who are prone to developing cardiac arrhythmias such as atrial fibrillation, atrial flutter and Wolff-Parkinson-White syndrome.