What is the importance of the onset of symptoms in the evaluation of atrial flutter (AFL)?

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Answer

Determining when the onset of symptoms occurred is critical, in that the duration of the episode affects management. For atrial flutter lasting longer than 48 hours, anticoagulation with warfarin or transesophageal echocardiography is required to rule out thrombus in the left atrium before cardioversion to sinus rhythm. In patients with a history of atrial flutter, the history should include precipitating causes and modes of termination of the arrhythmia.


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