Atrial Flutter - Atrial Dysrhythmias.
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- Atrial Flutter occurs when there is an obstruction within the atrial electrical conduction system.
- Due to this impediment a series of rapid depolarizations occur.
- These depolarizations may occur two, three, four or more times per QRS complex.
- The AV node functions like a “gatekeeper” blocking the extra impulses until the ventricular conduction system is able to accept the impulse.
- The impulse that is accepted will cause the QRS complex to occur.
- Each flutter wave represents atrial depolarization. This will be noted next to the P wave step in rhythm analysis. Instead of P waves, this tracing has “F” waves. No P waves mean there is no PR interval measurement.
- When the tracing is interpreted, the ratio of F waves to each QRS complex will be documented along with the rhythm i.e. Atrial Flutter 4:1 (indicates 4 “F” waves to each QRS complex). Not all Atrial Flutter will have a regular rhythm. In that case just document and report your observations.
- Analyze this tracing using the five steps of rhythm analysis.
- Compare your answers with the answers on the next slide.
Practice Strip Answers
- Rhythm: Regular
- Rate: Ventricles - 80, Atria - 320
- P wave: "F" waves
- PR interval: absent
- QRS: 0.08
- Interpretation: Atrial Flutter 4:1
Authors and ReviewersAuthored by Thomas O'Brien
Medically reviewed by Dr. Jonathan Keroes, MD, Cardiology
Last Update: 11/8/2020