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Counterclockwise and (Left) vs Clockwise (Right) Flutter
Typical atrial flutter is counterclockwise in direction and originates from
Typical atrial ... Atypical atrial ... from the left atrium ... #EKG #Cardiology ... #Classification
Tachyarrhythmia Framework - Differential Diagnosis
 • Narrow QRS - Regular Rhythm: Sinus tachycardia, AVNRT, Orthodromic AVRT,
, Atrial Tachycardia ... , Atrial flutter ... flutter w/ variable ... flutter with variable ... #Diagnosis #cardiology
Tachycardia - Differential Diagnosis Framework
Narrow-Complex:
 • Regular: Sinus Tachycardia, Junctional Tachycardia, Atrial Tachycardia, Atrial Flutter, AVRT
Tachycardia, Atrial ... Flutter, AVRT ( ... • Irregular: Atrial ... Flutter (w/ variable ... #Diagnosis #cardiology
Tachycardia - Differential Diagnosis and Management - Narrow vs Wide, Regular vs Irregular
Narrow - Regular:
Use P
/AVNRT. ... If see flutter p ... • Atrial Flutter ... If not Flutter P ... Diagnosis #Management #cardiology
Narrow Complex Tachycardias (Simplified)

Irregular Narrow Complex Tachycardia:
 1. Atrial fibrillation
	- Usually the correct answer
 2. Multifocal
Atrial fibrillation ... Multifocal Atrial ... Atrial flutter ... (Ectopic) Atrial ... #cardiology
Anatomical Differential Diagnosis for Arrhythmias
 • SA node: Sinus bradycardia, Sick Sinus Syndrome (SSS)
 • AV
: Premature Atrial ... Flutter (AFL), ... Atrial Fibrillation ... #Diagnosis #Causes ... #cardiology
Arrhythmias - Differential Diagnosis Algorithm

Bradyarrhythmia (<60 bpm)
 • Sinus Bradycardia
 • Sick Sinus Syndrome
 • SA
• Premature atrial ... Monofocal Ectopic Atrial ... Tachycardia • Aflutter ... • AFib • AFIutter ... • Multifocal Atrial
1. "Sinus Tach" at ~150 bpm is your cue to look for flutter waves
2. Don't trust
cue to look for flutter ... #Clinical #EM #Cardiology ... #ECG #Atrial #Flutter
Atrial Flutter on Neck Examination

If you can dx this rhythm, you are born before 1960. 
Early
Atrial Flutter on ... AVNRT would show ... JamesOngMD #Atrial ... #PhysicalExam #JVP ... Clinical #Video #Cardiology
Treatment of Stable Narrow-Complex Tachycardia
Regular Rhythm:
 • Attempt vagal maneuvers
 • Give adenosine 6 milligrams IV
convert - Possible atrial ... flutter, ectopic ... atrial tachycardia ... Rhythm: • Probable atrial ... flutter or MAT