Figure 11. Ongoing Management of Atrial Flutter
Atrial flutter
Catheter
ablation
(Class I)
Treatment
strategy
Beta blockers,
diltiazem,
or verapamil
(Class I)
Flecainide or
propafenone
(in the
absence of
SHD)
b
(Class IIb)
a
Aer assuring adequate anticoagulation or excluding LA thrombus by transesophageal
echocardiography before conversion.
b
Should be combined with AV nodal-blocking agents to reduce risk of 1:1 conduction
during atrial flutter.
Rate control Rhythm control
a
If ineffective
Amiodarone,
dofetilide, or
sotalol
(Class IIa)
Options to consider
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