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Fibrilasi atrium dan atrial flutter

Hauda El Rasyid

Sub bagian Aritmia / elektrofisiologi

FK UNAND/ RSUP DR. M. Djamil Padang

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Introduction

Atrial fibrillation (AF)

• 1% to 2% population, increased with age, others conditions

• mortality 1.5- to 2-fold and 5-fold for stroke

• Atrial rate : 300-600 bpm

• irregular f waves with an undulating baseline (irregularly


irregular)

• f waves coarse become fine as a nearly flat line

Carlo Pappone in catheter Ablation of Cardiac Arrhythmias Basic Concepts and Clinical Applications
Third Edition Edited by Wilber J David . Australia 2008 : 223-236
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Introduction, cont’d

Atrial Flutter (AFL)

• Before or concomittan with AF

• Sawtooth-like atrial waves

• Regular or irregular flutter waves (variable AV conduction) ,


240 - 340 bpm

• without an underlying isoelectric line


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2014 AHA/ACC/HRS Guideline
for the Management of Patients
With Atrial Fibrillation

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Atrial flutter is a macroreentrant tachyarrhythmia most
often contained within the right atrium. Typical atrial flutter
is defined on an electrocardiogram by the classic
“sawtooth” pattern of flutter waves with negative polarity
in leads II, III, and aVF. In contrast to atrial fibrillation,
which is sustained by multiple reentrant wavelets defined
by anatomic and/or functional barriers, typical atrial flutter
is sustained by a single reentrant circuit defined by
anatomical barriers.
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SR does not improve prognosis, but associated with a 47% lower risk for death
compared with continuing AF
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Carlo Pappone in catheter Ablation of Cardiac Arrhythmias Basic Concepts and Clinical Applications 2008 : 223-236
Electrical Cardioversion
≥ 1 of haemodinamic instability :
 Altered mental state
 Syock
 Hypotention
 Ischemic chest pain
 Heart Failure
 Informed corncern, do not forget sedation
 AFL : 50-100 Joule, AF 120-200 J synchronize,
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Stable haemodynamic : Acute rate control

2014 AHA/ACC/HRS Guideline


for the Management of Patients
With Atrial Fibrillation

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Acute rhytme control, cont’d

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• Terima kasih

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avnrt

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