Atrial Flutter
Typical atrial flutter is a macroreentrant atrial tachycardia, classically involving the cavotricuspid isthmus; atypical flutters use other circuits.
1. What might the surface ECG tell us?
Flutter-wave morphology and atrial activity can suggest typical versus atypical patterns, but EP confirmation may be needed.
2. What might we see intracardially?
Sequential atrial electrograms demonstrate organized atrial activation around a circuit.
Technologist mindset
Describe the sequence before naming the mechanism. Ask what is earliest, what follows, whether atrial and ventricular activation are linked, and whether the pattern changes with pacing.
3. Pacing clues
Entrainment and activation mapping can help determine whether a site participates in the reentrant circuit.
4. Mapping concept
Mapping defines activation around the circuit and identifies a critical isthmus that can be interrupted.
5. Ablation concept
For typical flutter, the procedural concept is interruption of conduction through the cavotricuspid isthmus with confirmation of block.
Quick knowledge check
What is the best learning sequence for AFL?
Professional reference
Open professional guidance →
Founder-authored educational summary. External expert review is not implied unless specifically stated.