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Atrial flutter

Última revisión: 17 Aug 2025
Última actualización: 10 Dec 2024

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • worsening heart failure or pulmonary symptoms
  • jugular venous pulsations with rapid flutter waves
Todos los datos

Otros factores de diagnóstico

  • palpitations
  • fatigue or lightheadedness
  • chest pain
  • dyspnea
  • syncope
  • hypotension
  • embolic events
Todos los datos

Factores de riesgo

  • increasing age
  • valvular dysfunction
  • atrial septal defects
  • atrial dilation
  • recent cardiac or thoracic procedures
  • surgical or postablation scarring of atria
  • heart failure
  • hyperthyroidism
  • COPD
  • asthma
  • pneumonia
  • antiarrhythmic drugs for atrial fibrillation
  • diabetes
  • digitalis use
  • male sex
  • congenital or lone atrial flutter
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • ECG
  • thyroid function tests
  • serum electrolytes
Todos los datos

Tests to avoid

  • imaging stress tests
  • coronary CT angiography
Todos los datos

Pruebas diagnósticas que deben considerarse

  • pulmonary function tests
  • CXR
  • digitalis level
  • cardiac enzymes
  • spiral CT with pulmonary embolism protocol
  • transthoracic echocardiogram
  • atrial electrogram recording
  • electrophysiologic studies
Todos los datos

Algoritmo de tratamiento

Inicial

hemodynamically unstable

Agudo

hemodynamically stable

En curso

recurrent atrial flutter or failure of elective cardioversion

Colaboradores

Autores

Katherine C. Wu, MD, FACC

Associate Professor of Medicine

Johns Hopkins University

School of Medicine

Baltimore

MD

Divulgaciones

KCW declares that she has no competing interests.

Peer reviewers

Richard C. Wu, MD

Associate Professor of Medicine

Director

Cardiac Electrophysiology Laboratory

UT Southwestern Medical Center

University Hospital

St. Paul

Dallas

TX

Disclosures

RCW declares that he has no competing interests.

Reginald Ho, MD

Clinical Assistant Professor

Department of Medicine

Thomas Jefferson University Hospital

Philadelphia

PA

Disclosures

RH declares that he has no competing interests.

George Juang, MD, FACC

Director of Electrophysiology

Long Island Arrhythmia Center

Mineola

NY

Declarações

GJ declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Page RL, Joglar JA, Caldwell MA, et al. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia. J Am Coll Cardiol. 2016 Apr 5;67(13):e27-115.Texto completo  Resumo

Hindricks G, Potpara T, Dagres N, et al. ESC Scientific Document Group. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021 Feb 1;42(5):373-498.Texto completo  Resumo

Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2024 Jan 2;149(1):e1-156.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Atrial flutter images
  • Diagnósticos diferenciais

    • Atrial fibrillation
    • Atrial tachycardia
    Mais Diagnósticos diferenciais
  • Diretrizes

    • 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines​
    • 2020 ESC guidelines for the diagnosis and management of atrial fibrillation
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Atrial fibrillation: what is it?

    Atrial fibrillation: what are the treatment options?

    Mais Folhetos informativos para os pacientes
  • Calculadoras

    Atrial Fibrillation CHA(2)DS(2)-VASc Score for Stroke Risk

    HAS-BLED Bleeding Risk Score

    Mais Calculadoras
  • Videos

    Electrical (direct current) cardioversion animated demonstration

    Mais vídeos
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