When is patient transfer indicated for the treatment of atrial flutter?

Updated: Nov 09, 2018
  • Author: Jesse Borke, MD, FACEP, FAAEM; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Transfer to a referral center may be indicated for patients who present to the emergency department with complications of atrial flutter, including the following:

  • Bradycardia (eg, from sick sinus syndrome) requiring pacemaker therapy
  • Unresponsive rate despite adequate medical therapy; after electrical cardioversion, referral for electrophysiologic ablation may be appropriate (These patients are generally transferred from one inpatient facility to another.)
  • Embolic complications requiring surgical therapy (ie, arterial embolization), cerebrovascular accident, atrial fibrillation, or atrial flutter requiring neurointensive care

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