Figure 10. Acute Treatment of Atrial Flutter
Hemodynamically
stable
YES
NO
Synchronized
cardioversion
b
,
oral dofetilide, IV
ibutilide, and/or
rapid atrial pacing
b
(Class I)
Treatment
strategy
Treatment
strategy
IV beta
blockers, IV
diltiazem, or
IV verapamil
(Class I)
IV
amiodarone
(Class IIa)
a
Anticoagulation as per guideline is mandatory.
b
For rhythms that break or recur spontaneously, synchronized cardioversion or rapid atrial
pacing is not appropriate.
Rate control Rhythm control
a
Rate control Rhythm control
a
Synchronized
cardioversion
(Class I)
IV
amiodarone
(Class IIa)
21
