What is the role of ventricular rate in the diagnosis 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

The ventricular rate reflects a fixed mathematical relation between the flutter waves and the resulting QRS complexes. Variable atrioventricular (AV) conduction can also be seen; patients commonly present with 2:1 AV conduction. With 1:1 AV conduction, hemodynamic collapse may occur. Deterioration to 1:1 conduction can occur in patients with healthy hearts, but it is a particular risk in patients with a preexcitation syndrome (Wolff-Parkinson-White). An ECG clue to a preexcitation syndrome is a very short PR interval (<0.115 s) and delta wave.


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