Community Management of Atrial Flutter

 

• Admit if haemodynamically unstable (eg systolic BP <90)
• History, examination, ECG, bloods, CXR, echocardiogram to be considered as for atrial fibrillation.
• Assess need for thromboprophylaxis using CHA2DSVASc score and commence anticoagulation as appropriate. Although the risk of thomboembolism is lower than for atrial fibrillation the same algorithm is used.
• Commence rate controlling agents if necessary (Use B-Blocker as first line)
• Flutter is more successfully restored to sinus rhythm than atrial fibrillation by both DC cardioversion and ablation. Therefore recommend a lower threshold for referral for rhythm control strategy.

 

Please refer patient unless:

• Patient  is asymptomatic and does not want to be considered for DC cardioversion/ ablation
• The patient is unsuitable for D-C cardioversion e.g. biologically elderly+/- multiple comorbidities and therefore at higher risk from anaesthetic.

 

Date reviewed                     05/07/2021

Next review due                  05/07/2022

Sifter name                         Elizabeth Fell / Bridgitte Wesson

Contributors                        Dr Louise Melley – Assistant Specialist Cardiology RCHT

 

Version 1.3