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Feature Article

Atrial flutter: the organised cousin of atrial fibrillation

Sonali Gnanenthiran, Maros Elsik

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Abstract

Atrial flutter shares many characteristics with atrial fibrillation, but it is important to distinguish between these arrhythmias because of the varying underlying electrophysiology and response to therapy.

Key Points

  • Although electrophysiologically different from atrial fibrillation (AF), atrial flutter (AFL) shares many characteristics, especially in terms of its pharmacological medical management.
  • AFL can be classified as ‘typical’ or ‘atypical’ based on its anatomical and electrophysiological characteristics.
  • Treatment of AFL focuses on identifying and treating reversible causes, controlling the ventricular rate and/or achieving sinus rhythm as well as reducing the risk of systemic embolisation.
  • Radiofrequency ablation is generally regarded as a first-line therapy for typical flutter.

    Picture credit: © Science Source/Gary Carlson/Diomedia.com

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