Re-entrant tachycardias hit a fast rate suddenly and maintain that rate until they end suddenly. For example, if your patient talks or moves around in bed, the rate may go up slightly.

Remember that sinus rhythms tend to fluctuate slightly. Suspect any tachycardiaĪny rhythm around 150 bpm should be suspected of being atrial flutter with 2:1 conduction. Here are 10 tips to avoid missing atrial flutter. You won't find atrial flutter it if you aren’t looking for it. 10 tips to avoid missing atrial flutter with 2:1 conduction. As cardiac output is decreased and cardiac workload increased, ventricular fibrillation can result. In patients with accessory pathways that bypass the slow conduction of the AV node, like Wolff-Parkinson-White Syndrome, 1:1 conduction of atrial flutter or atrial fib can be life-threatening. Atrial flutter can lead to fast rates at 2:1 conduction, and VERY fast rates at 1:1 conduction.

When we see slower ventricular rates and conduction ratios of 3:1 or more, it is usually due to medications or other causes of enhanced refractoriness of the AV node. New-onset atrial flutter is most often conducted 2:1, because that is a comfortable rate (around 150 per minute) for the AV node to conduct. The AV node is bombarded by a regular atrial rhythm of around 300 per minute. It can occur suddenly, and is sometimes associated with periods of atrial fibrillation. Atrial flutter is a re-entrant tachycardia that occurs in the atria.

Afib vs a flutter