[Typical and atypical atrial flutters]

Abstract

Definitions, classification, surface electrocardiographic characterisitics, risk for stroke and treatments. Atrial flutters are macro-reentrant circuits originated from both right and left atria. They have been classified in typical and atypical based on their cavo-tricuspid isthmus-dependence. Typical atrial flutter comprises counterclockwise and clockwise isthmus-dependent atrial flutter located within the right atrium. Atypical atrial flutters are composed by non-isthmus-dependent right atrial flutter and left atrial flutter. Typical atrial flutter represents at least 90% of all flutters, and has usually a counterclockwise pattern. Ablation is a potential definitive therapy for atrial flutter. However, successful procedures as well as complications rates are different depending of the location of the circuit. There are now evidences for risk of stroke related to atrial flutter, although epidemiological studies have not been conducted yet. Therefore, prevention of such complications using anti-thrombotic should be performed as done for atrial fibrillation.