Atrial Flutter
Atrial flutter management — cardioversion at lower energy, rate control often harder than AF
Overview
- Atrial flutter management — cardioversion at lower energy, rate control often harder than AF
Protocol steps
- id: 1; title: Unstable — Synchronized Cardioversion; detail: Flutter cardioverts at lower energy than AF. Start at 50-100J biphasic synchronized. Sedate if time permits.; time: ; drugs:
- id: 2; title: Rate Control; detail: Note: Flutter is often harder to rate-control medically than AF. Lower threshold for cardioversion. Same agents as AF.; time: ; drugs: name: Diltiazem; dose: 0.25 mg/kg IV bolus over 2min; interval: then 5-15 mg/hr drip; name: Metoprolol; dose: 5mg IV; interval: q5min x3 doses
- id: 3; title: Cardioversion Consideration; detail: If rate control not achieved, cardioversion is often more effective for flutter than for AF. Same onset duration rules apply (<48h vs >48h).; time: ; drugs: ; branch: true
- id: 4; title: Anticoagulation; detail: Same principles as AF. CHA2DS2-VASc scoring applies. Flutter carries similar stroke risk to AF.; time: ; drugs:
Source and review
- AHA/ACC/HRS AF Guidelines 2023; Page et al., Circulation 2016. Last reviewed: 2024-11-01