- More organized, saw-tooth type pattern seen on standard 12-lead EKG.
- Negative flutter waves in inferior leads
- Positive flutter waves in V1
- Typical Flutter = counterclockwise reentry around tricuspid annulus.
- Rate is ~250/min; noted as 2:1 or 4:1 for its atrial rate and the ratio of electrical conduction down the AV node.
- Atrial Flutter is often seen in patients diagnosed with concomitant Atrial Fibrillation (Fib-Flutter).
- Similar to AFib – think CHA2DS2-VASc for stroke prevention.
- Benefit of Rate vs. rhythm control is the same.
- CAN require larger doses of AV nodal blockers (CCBs or BBs).
- Catheter ablation for typical flutter is generally preferred (high success rate).
ACP MKSAP 17: Cardiovascular Medicine, pp. 58