This appears as positively-directed flutter waves in the inferior leads.Ītypical atrial flutter originates from the left atrium or areas in the right atrium (such as surgical scars) and has a variable appearance on ECG in regards to the flutter waves. At times, the direction of the circuit can reverse, causing clockwise atrial flutter from the same anatomical location. This results in negatively-directed flutter waves in the inferior leads. Typical atrial flutter is counterclockwise in direction and originates from a reentrant circuit around the tricuspid valve annulus and through the cavo-tricuspid isthmus. Also, atrial flutter can be described as “clockwise” or “counterclockwise” depending on the direction of the circuit. type II) based on the anatomic location that it originates. Pathophysiology – Atrial FlutterĪtrial flutter can described as “typical” (a.k.a. Frequently, a 2:1 conduction ratio occurs, resulting in a ventricular rate of 150 bpm. The atrial rates during atrial flutter vary from 250 to 350 beats per minutes, slower than the 400 to 600 bpm seen in atrial fibrillation. This anatomically makes ablation much easier than in atrial fibrillation, which occurs in the pulmonary veins. Typical atrial flutter results from a reentrant circuit around the tricuspid valve and through the cavo-tricuspid isthmus. Atrial flutter is similar to atrial fibrillation in that the rhythm originates in the atrium and causes a narrow complex tachycardia, which carries thromboembolic risk.
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