[Atrial flutter and fibrillation].
This article summarizes current understandings and therapies for both arrhythmias. Atrial flutter is most often arising from a macroreentry circuit in the right atrium or around scar tissue in case or previous cardiothoracic surgery. As a macroreentrant tachycardia it is regular and can lead to higher heart rates, especially if occurring with 1:1 conduction. In contrast atrial fibrillation, especially when occurring paroxysmal at the beginning, is arising from triggers within the pulmonary veins. Ablation strategies to electrically isolate those triggers have a treatment success rate of 80%, which is much more than can be achieved with antiarrhythmic medication (success rates 30-50%). Emergency treatment of both arrhythmias include cardioversion and pacemaker implantation with AV node ablation if necessary.
Scharf
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HerzGefässZentrum, Klinik im Park, Zürich. Christoph.Scharf@gmail.com
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D001282:Atrial Flutter / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D017115:Catheter Ablation; D002986:Clinical Trials as Topic; D004206:Disopyramide / Q000627:therapeutic use; D004554:Electric Countershock; D004562:Electrocardiography; D004630:Emergencies; D005424:Flecainide / Q000627:therapeutic use; D006339:Heart Rate; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011405:Propafenone / Q000627:therapeutic use; D011802:Quinidine / Q000627:therapeutic use; D012008:Recurrence; D013015:Sotalol / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers; D013449:Sulfonamides; D014665:Vasodilator Agents; C067192:ibutilide; D011405:Propafenone; D013015:Sotalol; D004206:Disopyramide; D011802:Quinidine; D005424:Flecainide; D000638:Amiodarone