Pathogenesis (disease development)
Atrial flutter is a cardiac arrhythmia with intraatrial excitation circling by macro-reentry (circling excitation) along the tricuspid annulus (heart valve between the right atrium and the right ventricle), resulting in a regular undulating (wave-like) rhythm. This shows a typical atrial rate of 240-350/min, often 2 to 1 crossed over i.e. ventricular rate is 120-170/min.
Etiology (Causes)
Biographic causes
- Age of life – older age
Behavioral causes
- Nutrition
- Opulent meal (sumptuous food)
- Micronutrient deficiency (vital substances) – see Prevention with micronutrients.
- Consumption of stimulants
- Alcohol (woman: > 15 g/day; man: > 20 g/day).
- Overweight (BMI ≥ 25; obesity).
Disease-related causes
- Acute respiratory insufficiency – respiratory failure with resulting oxygen deficiency.
- Chronic obstructive pulmonary disease (COPD) (1.9-fold increase in incidence).
- Chronic kidney disease
- Diabetes mellitus
- Heart disease of various etiologies; including.
- Heart failure/heart failure (3.5-fold increased risk).
- Valvular heart disease
- Hypertension (high blood pressure)
- Pericarditis (inflammation of the pericardium)
- Coronary artery disease (CAD; coronary artery disease).
- Condition n. Myocardial infarction (heart attack)
- Metabolic syndrome
- Hyperthyroidism (overactive thyroid gland)
- Sleep-related breathing disorders (SBAS)
Medication
- Flecainide and propafenone (sodium channel blockers)-may induce 1:1 AV conduction and widen the QRS interval in patients with atrial flutter; when using these medications in patients with atrial flutter, an AV nodal-blocking medication should also be prescribed.
Other causes
- After open-heart surgery.