The Clinical Features of Atrial Flutter and Their Therapeutic Implications

Abstract

Analysis of 71 patients with atrial flutter delineated two categories of patients. One group (40 patients) had severe decompensated heart disease. Another group (31 patients) was free of structural heart disease or had disease not severe enough to result in congestive failure. Of the latter group 23 had an acute noncardiac illness. In 14 it was a disease of the bronchopulmonary system. Those patients with severe heart disease seldom reverted without electrical countershock during the first five days after hospital admission. The majority of the latter group reverted within five days without such therapy. Those observations are useful to the clinician who must select therapy for his patient with atrial flutter. Failure to appreciate this variability may lead to conflicting or misleading reports regarding the efficacy of newer forms of therapy. Analysis of 71 patients with atrial flutter delineated two categories of patients. One group (40 patients) had severe decompensated heart disease. Another group (31 patients) was free of structural heart disease or had disease not severe enough to result in congestive failure. Of the latter group 23 had an acute noncardiac illness. In 14 it was a disease of the bronchopulmonary system. Those patients with severe heart disease seldom reverted without electrical countershock during the first five days after hospital admission. The majority of the latter group reverted within five days without such therapy. Those observations are useful to the clinician who must select therapy for his patient with atrial flutter. Failure to appreciate this variability may lead to conflicting or misleading reports regarding the efficacy of newer forms of therapy. Atrial FlutterCHESTVol. 66Issue 2PreviewThe paper by Lindsay and Hurst on the “Clinical Features of Atrial Flutter” appearing in this issue (see page 114 ) presents a most interesting review of a group of selected patients with this arrhythmia as seen in a Veterans Hospital population. The highly selective nature of this study probably accounts for a difference in our experience as contrasted to the authors’, since in a survey of 200 patients with chronic obstructive lung disease1 our group did not find any instance of atrial flutter. The division into two groups by the authors (those with and those without congestive [ventricular] failure) has physiologic as well as therapeutic implications. Full-Text PDF