atrial flutter

• in atrial flutter, atrial rate is greater than 250 bpm with no flat baseline
• atrial flutter can be difficult to recognise if there is second degree AV block, but for the flutter to be more obvious we can do vagal stimulation
• DC cardioversion can be used on patients that are haemodynamically unstable
• treatment of atrial flutter include:(benzodiazepine) Midazolam IV, 1-2.5 mg administered over 2-3min .
• cardioversion is urgent if the patient is deveping severe symptoms or HF
• do not use verapamil(CCB) because it may cause hypotension, and it does not convert flutter to sinus rhythm