Atrial Flutter

Key points

• SVT with rapid regular atrial depolarisation waves — 'sawtooth' ECG.
• Atrial rate ~300/min; ventricular rate depends on AV block (2:1 block → 150/min).
• Flutter waves may be unmasked by carotid sinus massage or adenosine.
• Management similar to AF but medication less effective; more sensitive to cardioversion (lower energies).
• Radiofrequency ablation of the tricuspid valve isthmus is curative for most patients.

Decision points in this pathway

• Unstable or persistent?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.