Overview

• Common type of supraventricular tachycardia characterized by uncoordinated atrial activation that results in an irregular ventricular response
  • Acute → <48 hrs
  • Paroxysmal → if AF terminates spontaneously. Terminates within 7 days (most commonly occurs within 24 hrs).
  • Persistent → continues for >7 days but is amended to cardioversion
  • Permanent → cannot achieve sinus rhythm (ie. can not be cardioverted)
• Caues → IHD, HF, Hypertension, Mitral Valve Disease, Hyperthyroidism, PE, Pneumonia, Alcohol
• Very common in the elderly

Atrial Flutter → form of supraventricular tachycardia characterised by a succession of rapid atrial depolarisation waves. Sawtooth pattern. 2:1 ratio of p waves:QRS complexes (ie. 2:1 ratio of atrial impulses being conducted to the ventricles).

Making Diagnosis

Clinical Features:

• ‘Irregularly Irregular’ Pulse
• Palpitations
• Chest Pain
• Dyspnoea
• Faintness

Investigations:

• ECG → absent P waves, irregular QRS complexes, irregularly irregular RR intervals
  • AF ECG
• Transthoracic Echocardiogram → rule out underlying cardiac structural disease (ie. valvular disease)
• TFTs → check for hyperthyroidism