How is pediatric atrial flutter diagnosed?

Updated: Feb 04, 2019
  • Author: M Silvana Horenstein, MD; Chief Editor: Syamasundar Rao Patnana, MD  more...
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A 12-lead to 15-lead electrocardiogram (ECG) is the mainstay of atrial flutter diagnosis. Atrial flutter is a reentrant arrhythmia circuit confined to the atrial chambers. Such a circuit may be macroscopic and, therefore, amenable to mapping by techniques using standard electrophysiologic catheters or it may be microscopic and amenable to mapping only in the research laboratory using fine electrode arrays.

Depending on the drug used, patients receiving antiarrhythmic therapy may benefit from the monitoring of specific drug blood levels and electrolyte and creatinine levels or ECG monitoring of the QTc (eg, class III agents).

Electrophysiologic studies may be useful for mapping arrhythmia circuits. Consider transesophageal echocardiography in patients with associated structural or functional heart disease to ascertain the presence of intracardiac thrombi, myocardial dysfunction, or hemodynamically important residual structural defects that could predispose them to atrial flutter.

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