Atrial Flutter

• Atrial flutter is a macro reentrant circuit in the right atrium
• Atrial flutter has one reentrant circuit, AF demonstrates multiple random reentrant circuits

Atrial Fibrillation (AFib)

• No "P-waves" - just 300-500 random electrical signals per minute
• "Irregularly irregular"
  
• AFib is the most common sustained arrhythmia
• Can lead to clot formation and systemic embolic events
  

Etiology of new-onset AFib (P-I-R-A-T-E-S)

• Pulmonary disease (COPD, PE)/Phaeochromocytoma
• Ischemia (ACS)
• Rheumatic heart disease (mitral stenosis)
• Anemia (high output failure/tachycardia)/Atrial myxoma/Acid-base disturbance
• Thyrotoxicosis (tachycardia)
• Ethanol/Endocarditis/Electrolyte disturbance (hypokalaemia, hypomagnesaemia)/Elevated BP
• Sepsis/Sick Sinus Syndrome/Sympathomimetics (Drugs)

Treatment of AFib

• Rate vs rhythm control
  
• Stable patient in AFib < 48 hours
• Cardioversion
• Electrical
• Pharmacologic

Anticoagulation

• CHADS-2 Score