12/27/2023 0 Comments A flutter ekgStudies have shown that lower doses between 20-50 J are adequate for the conversion of atrial flutter. The page which states that 20-50 J can is used for the conversion of atrial flutter is speaking about atrial flutter in general and this could mean both stable and unstable atrial flutter. Synchronized cardioversion is indicated, and the starting dose for narrow, regular tachycardia would be 50 J. Q: Energy levels for cardioversion of unstable a-flutter with both biphasic and monophasic devices? I haven’t seen anything as low as 20-50 joules mentioned in the AHA material, but I’m just getting started.Ī: Unstable atrial flutter is treated as an unstable tachycardia within the tachycardia algorithm. You would want to perform a TEE to ensure that there is no thrombus formation and you would want to initiate anticoagulation therapy. Q: What are the chances of the formation of thrombus in the atrial cavity in the case of long-standing atrial flutter? Do we have to give anticoagulation, as in atrial fibrillation, to minimize the risk of emboli?Ī: The chances for thrombus formation are relatively high. (3.84 mb)Ĭlick for next Rhythm Review: Atrial Fibrillation Questions Asked On This Page Please allow several seconds for the video to load. 20-50J is commonly enough to revert to sinus rhythm.ĪHA recommends an initial shock dose 0f 50-100 J for cardioverting unstable atrial flutter.īelow is a short video which will help you quickly identify atrial flutter on a monitor. CardioversionĪtrial flutter is considerably more sensitive to electrical direct-current cardioversion than atrial fibrillation, and usually requires a lower energy shock. Drugs are not used to manage unstable tachycardia. When atrial flutter produces hemodynamic instability and serious signs and symptoms, it is treated using ACLS protocol.įor the patient with unstable tachycardia due to this tachyarrhythmia (atrial flutter), immediate cardioversion is recommended. Treatmentįor the purposes of ACLS, atrial flutter is treated the same as atrial fibrillation. Prevent complications from atrial flutter with early cardioversion. Ineffective atrial contractions can lead to thrombus formation in the atria and rapid ventricular rates can cause decompensation and heart failure. These complications are usually due to ineffective atrial contractions and rapid ventricular rates.
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