Daily Archive 01.03.2019

Frequent Atrial Stimulation

Atrial stimulation (within 30 s) with a frequency that is approximately 25% higher than the natural frequency of atrial contractions often leads to the restoration of sinus rhythm. It may take several attempts at such stimulation to stop TP. Sometimes this may cause AF, but usually within a few hours (and often within a few minutes) there is a recovery in sinus rhythm.

It is important to ensure that the applied stimuli ensure the capture of the atrial rhythm. Signs of such seizure are usually an increase or decrease in the frequency of ventricular contractions depending on the state of AV conduction.

The advantage of the method is that it does not require general anesthesia and substantial sedative preparation. If atrial flutter develops during cardiac surgery and electrodes for temporary atrial stimulation have not yet been extracted, they can be used to relieve arrhythmia.

Systemic embolism in atrial flutter (TP)

Like AF, TP can cause systemic embolism. The limited data available suggests that their risk is lower than with AF. Perhaps this is due to the fact that with TP some mechanical activity of the atria is preserved, and therefore the likelihood of thrombus formation in the atrium is reduced.

However, according to current guidelines, the need for prescribing anticoagulants to patients with TA should be assessed using the same stroke risk scale used for AF. Perhaps in some cases, systemic emboli in patients with atrial flutter (TP) are due to episodes of paroxysmal AF.

Reception of warfarin can be stopped after 6 weeks. after successful ablation for atrial flutter (TP), but on condition that no evidence of paroxysmal AF is obtained (outpatient ECG monitoring reduces the likelihood that AF will be skipped).