What is the best treatment for the new-onset atrial flutter?
Recent-onset atrial flutter: Electrical cardioversion of low-intensity 25-50 J can conve 90% of patients into normal sinus rhythm and is most effective therapy. In atrial flutter usage of class I agents(Procainamide) will lead to the slowing of atrial flutter to a point where 1:1 conduction will occur and hea rate can jump up to 200 bpm leading to hemodynamic compromise. Ibutilide: 1 mg infusion over 60 minutes will work in 50-70% of patients reveing them to normal sinus rhythm. However, it is not given in the choices. Recurrent atrial flutter: Anti-arrhythmic drugs like sotalol, amiodarone can be used but 70% will experience recurrence. In this situation catheter ablation at cavotricuspid isthmus is more effective.
Cardioversion
Procainamide
Bretylium
Amiodarone
ECG and Arrhythmia 2