Atrial flutter causes: Difference between revisions

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{| class="infobox" style="float:right;"
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| [[File:Siren.gif|30px|link=Atrial flutter resident survival guide]]|| <br> || <br>
| [[Atrial flutter resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
|}
{| class="infobox" style="float:right;"
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| [[File:Critical_Pathways.gif|88px|link=Atrial flutter critical pathways]]|| <br> || <br>
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{{Atrial flutter}}
{{Atrial flutter}}
{{CMG}}; {{VR}}
{{CMG}}; {{AE}} {{VR}}


==Overview==
==Overview==
Atrial flutter is caused by a re-entrant rhythm in either the right or left atrium.  Causes of atrial flutter can be grouped into two categories, intrinsic diseases and abnormalities of the heart and diseases elsewhere in the body that can affect the heart.  Most common causes of atrial flutter are [[coronary artery disease]], [[Hypertension|hypertensive heart disease]] and valve abnormalities of the heart.  
Atrial flutter is caused by a re-entrant rhythm in either the right or left [[atrium]].  Causes of atrial flutter can be grouped into two categories which are intrinsic diseases of the heart and extrinsic diseases that can affect the heart.  The most common causes of atrial flutter are [[coronary artery disease]], [[Hypertension|hypertensive heart disease]] and [[valvular heart disease|valve abnormalities]] of the heart.


==Causes==
==Causes==
===Life Threatening Causes===
===Life Threatening Causes===
Life-threatening causes include conditions which result in death or permanent disability within 24 hours if left untreated.
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.


*[[Carbon monoxide poisoning#Symptoms|Carbon monoxide poisoning]]
*[[Carbon monoxide poisoning#Symptoms|Carbon monoxide poisoning]]
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*[[Cardiomyopathy natural history, complications and prognosis|Cardiomyopathy]]
*[[Cardiomyopathy natural history, complications and prognosis|Cardiomyopathy]]
*[[Congenital heart disease]]
*[[Congenital heart disease]]
*[[Hypertension]]
*[[Hypertensive heart disease]]
*[[Hyperthyroidism history and symptoms|Hyperthyroidism]]
*[[Hyperthyroidism history and symptoms|Hyperthyroidism]]
*[[Mitral stenosis|Mitral valve disease]]<ref name="pmid23280242">{{cite journal |author=Gutierrez SD, Earing MG, Singh AK, Tweddell JS, Bartz PJ |title=Atrial Tachyarrhythmias and the Cox-maze Procedure in Congenital Heart Disease |journal=Congenit Heart Dis |volume= |issue= |pages= |year=2012 |month=December |pmid=23280242 |doi=10.1111/chd.12031 |url=}}</ref> <ref name="Granada-2000">{{Cite journal  | last1 = Granada | first1 = J. | last2 = Uribe | first2 = W. | last3 = Chyou | first3 = PH. | last4 = Maassen | first4 = K. | last5 = Vierkant | first5 = R. | last6 = Smith | first6 = PN. | last7 = Hayes | first7 = J. | last8 = Eaker | first8 = E. | last9 = Vidaillet | first9 = H. | title = Incidence and predictors of atrial flutter in the general population. | journal = J Am Coll Cardiol | volume = 36 | issue = 7 | pages = 2242-6 | month = Dec | year = 2000 | doi =  | PMID = 11127467 }}</ref>
*[[Mitral stenosis|Mitral valve disease]]<ref name="pmid23280242">{{cite journal |author=Gutierrez SD, Earing MG, Singh AK, Tweddell JS, Bartz PJ |title=Atrial Tachyarrhythmias and the Cox-maze Procedure in Congenital Heart Disease |journal=Congenit Heart Dis |volume= |issue= |pages= |year=2012 |month=December |pmid=23280242 |doi=10.1111/chd.12031 |url=}}</ref> <ref name="Granada-2000">{{Cite journal  | last1 = Granada | first1 = J. | last2 = Uribe | first2 = W. | last3 = Chyou | first3 = PH. | last4 = Maassen | first4 = K. | last5 = Vierkant | first5 = R. | last6 = Smith | first6 = PN. | last7 = Hayes | first7 = J. | last8 = Eaker | first8 = E. | last9 = Vidaillet | first9 = H. | title = Incidence and predictors of atrial flutter in the general population. | journal = J Am Coll Cardiol | volume = 36 | issue = 7 | pages = 2242-6 | month = Dec | year = 2000 | doi =  | PMID = 11127467 }}</ref>
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{|style="width:80%; height:100px" border="1"
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Aortic regurgitation]],  [[aortic stenosis]],  [[atrial myxoma]],  [[Cardiomyopathy natural history, complications and prognosis|cardiomyopathy]],  [[congenital heart disease]],  [[congestive heart failure]],  [[coronary artery disease]],  [[dilated cardiomyopathy]],  [[hypertension]],  [[hypertrophic cardiomyopathy]],  [[ischemic heart disease]],  [[Lown-Ganong-Levine syndrome]],  [[mitral regurgitation]],  [[mitral valve prolapse]],  [[mitral valve stenosis]],  [[ST elevation myocardial infarction complications|myocardial infarction]],  [[myocardial ischemia]],  [[Coxsackie A virus#Diseases|neonatal coxsackie myocarditis]],  [[pericarditis]],  [[Rheumatic fever natural history#Complications|rheumatic fever]],  [[Rheumatic fever natural history#Complications|rheumatic heart disease]],  [[sick sinus syndrome]],  [[Wolff-Parkinson-White syndrome]]  
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Aortic regurgitation]],  [[aortic stenosis]],  [[atrial myxoma]],  [[Cardiomyopathy natural history, complications and prognosis|cardiomyopathy]],  [[congenital heart disease]],  [[congestive heart failure]],  [[coronary artery disease]],  [[dilated cardiomyopathy]],  [[holiday heart syndrome]],  [[hypertensive heart disease]],  [[hypertrophic cardiomyopathy]],  [[ischemic heart disease]],  [[Lown-Ganong-Levine syndrome]],  [[mitral regurgitation]],  [[mitral valve prolapse]],  [[mitral valve stenosis]],  [[ST elevation myocardial infarction complications|myocardial infarction]],  [[myocardial ischemia]],  [[Coxsackie A virus#Diseases|neonatal coxsackie myocarditis]],  [[pericarditis]],  [[Rheumatic fever natural history#Complications|rheumatic fever]],  [[Rheumatic fever natural history#Complications|rheumatic heart disease]],  [[sick sinus syndrome]],  [[Wolff-Parkinson-White syndrome]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Amphetamines]], [[disopyramide]],  [[flecainide]],  [[lithium]],  [[orlistat]],  [[procainamide]],  [[propafenone]],  [[quinidine]],  [[Antiarrhythmic agent#Class Ia agents|type Ia antiarrhythmic agents]],  [[Antiarrhythmic agent#Class Ic agents|type Ic antiarrhythmic agents]],  [[Antiarrhythmic agent#Class III agents|type III antiarrhythmic agents]]  
|bgcolor="Beige"| [[Amphetamines]], [[cyclophosphamide]], [[disopyramide]], [[febuxostat]],  [[flecainide]], [[Ixabepilone]], [[lacosamide]],  [[lithium]],  [[orlistat]],  [[procainamide]],  [[propafenone]],  [[quinidine]],  [[Antiarrhythmic agent#Class Ia agents|type Ia antiarrhythmic agents]],  [[Antiarrhythmic agent#Class Ic agents|type Ic antiarrhythmic agents]],  [[Antiarrhythmic agent#Class III agents|type III antiarrhythmic agents]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| [[Atrial myxoma]], [[lung cancer]]
|bgcolor="Beige"| [[Atrial myxoma]], [[lung cancer]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
| '''Overdose / Toxicity'''
|bgcolor="Beige"| [[Holiday heart syndrome|Alcohol (especially binge drinking)]], [[caffeine]], [[cocaine]], [[digitalis toxicity]]
|bgcolor="Beige"| [[Alcohol]], [[caffeine]], [[cocaine]], [[digitalis toxicity]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| [[Chronic obstructive pulmonary disease]], [[emphysema]], [[hypoxia]], [[lung cancer]], [[obstructive sleep apnea]], [[pneumonia]],  [[Pulmonary embolism natural history, complications and prognosis|pulmonary embolism]]
|bgcolor="Beige"| [[Chronic obstructive pulmonary disease]], [[emphysema]], [[hypoxia]], [[lung cancer]], [[obstructive sleep apnea]], [[pneumonia]],  [[Pulmonary embolism natural history, complications and prognosis|pulmonary embolism]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[The heart in juvenile rheumatoid arthritis#3. Systemic onset of juvenile idiopathic arthritis|juvenile idiopathic arthritis]], [[psoriatic arthritis]], [[reactive arthritis]], [[spondyloarthritis]]
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[The heart in juvenile rheumatoid arthritis#3. Systemic onset of juvenile idiopathic arthritis|juvenile idiopathic arthritis]], [[psoriatic arthritis]], [[reactive arthritis]], [[sarcoidosis]], [[spondyloarthritis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| [[Sarcoidosis]],  [[stress]]
|bgcolor="Beige"| [[Stress]]
|-
|-
|}
|}


===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
{{col-begin|width=80%}}
{{columns-list|
{{col-break|width=33%}}
*[[Alcohol]]
*[[Holiday heart syndrome|Alcohol (especially binge drinking)]]
*[[Amoebiasis]]<ref name="Murali-2011">{{Cite journal  | last1 = Murali | first1 = A. | last2 = Balu | first2 = K. | last3 = Paari | first3 = V. | last4 = Rajendiran | first4 = G. | title = Atrial flutter and pericarditis--a rare complication of right lobe amoebic liver abscess. | journal = Med J Malaysia | volume = 66 | issue = 5 | pages = 499-500 | month = Dec | year = 2011 | doi =  | PMID = 22390111 }}</ref>
*[[Amoebiasis]]<ref name="Murali-2011">{{Cite journal  | last1 = Murali | first1 = A. | last2 = Balu | first2 = K. | last3 = Paari | first3 = V. | last4 = Rajendiran | first4 = G. | title = Atrial flutter and pericarditis--a rare complication of right lobe amoebic liver abscess. | journal = Med J Malaysia | volume = 66 | issue = 5 | pages = 499-500 | month = Dec | year = 2011 | doi =  | PMID = 22390111 }}</ref>
*[[Amphetamines]]
*[[Amphetamines]]
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*[[Aortic stenosis]]
*[[Aortic stenosis]]
*[[Atrial myxoma]]
*[[Atrial myxoma]]
*[[Binge drinking]]
*[[Caffeine]]
*[[Caffeine]]
*[[Carbon monoxide poisoning]]
*[[Carbon monoxide poisoning]]
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*[[Coronary artery disease]]
*[[Coronary artery disease]]
*[[Crohn's disease]]
*[[Crohn's disease]]
*[[Cyclophosphamide]]
*[[Digitalis toxicity]]<ref name="FRIEDBERG-1960">{{Cite journal  | last1 = FRIEDBERG | first1 = CK. | last2 = DONOSO | first2 = E. | title = Arrhythmias and conduction disturbances due to digitalis. | journal = Prog Cardiovasc Dis | volume = 2 | issue =  | pages = 408-31 | month = Mar | year = 1960 | doi =  | PMID = 13825021 }}</ref>
*[[Digitalis toxicity]]<ref name="FRIEDBERG-1960">{{Cite journal  | last1 = FRIEDBERG | first1 = CK. | last2 = DONOSO | first2 = E. | title = Arrhythmias and conduction disturbances due to digitalis. | journal = Prog Cardiovasc Dis | volume = 2 | issue =  | pages = 408-31 | month = Mar | year = 1960 | doi =  | PMID = 13825021 }}</ref>
*[[Dilated cardiomyopathy]]
*[[Dilated cardiomyopathy]]
*[[Disopyramide]]
*[[Disopyramide]]
*[[Emphysema]]
*[[Emphysema]]
{{col-break|width=33%}}
*[[Flecainide]]
*[[Flecainide]]
*[[Heart bypass surgery]]
*[[Heart bypass surgery]]
*[[Hypertension]]
*[[Holiday heart syndrome]]
*[[Hypertensive heart disease]]
*[[Hyperthyroidism history and symptoms|Hyperthyroidism]]
*[[Hyperthyroidism history and symptoms|Hyperthyroidism]]
*[[Hypertrophic cardiomyopathy]]
*[[Hypertrophic cardiomyopathy]]
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*[[Catheter ablation|Incomplete ablation procedures]]
*[[Catheter ablation|Incomplete ablation procedures]]
*[[Ischemic heart disease]]
*[[Ischemic heart disease]]
*[[The heart in juvenile rheumatoid arthritis#3. Systemic onset of juvenile idiopathic arthritis|juvenile idiopathic arthritis]]
*[[Ixabepilone]]
*[[The heart in juvenile rheumatoid arthritis#3. Systemic onset of juvenile idiopathic arthritis|Juvenile idiopathic arthritis]]
*[[Lithium]]
*[[Lithium]]
*[[Lown-Ganong-Levine syndrome]]
*[[Lown-Ganong-Levine syndrome]]
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*[[Open heart surgery]]
*[[Open heart surgery]]
*[[Orlistat]]
*[[Orlistat]]
{{col-break|width=33%}}
*[[Pericarditis]]
*[[Pericarditis]]
*[[Pheochromocytoma]]
*[[Pheochromocytoma]]
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*[[Ulcerative colitis]]
*[[Ulcerative colitis]]
*[[Wolff-Parkinson-White syndrome]]
*[[Wolff-Parkinson-White syndrome]]
{{col-end}}
}}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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[[Category:Up-To-Date]]
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Latest revision as of 20:18, 10 January 2020
Resident
Survival
Guide
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Atrial flutter Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]

Overview

Atrial flutter is caused by a re-entrant rhythm in either the right or left atrium. Causes of atrial flutter can be grouped into two categories which are intrinsic diseases of the heart and extrinsic diseases that can affect the heart. The most common causes of atrial flutter are coronary artery disease, hypertensive heart disease and valve abnormalities of the heart.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Aortic regurgitation, aortic stenosis, atrial myxoma, cardiomyopathy, congenital heart disease, congestive heart failure, coronary artery disease, dilated cardiomyopathy, holiday heart syndrome, hypertensive heart disease, hypertrophic cardiomyopathy, ischemic heart disease, Lown-Ganong-Levine syndrome, mitral regurgitation, mitral valve prolapse, mitral valve stenosis, myocardial infarction, myocardial ischemia, neonatal coxsackie myocarditis, pericarditis, rheumatic fever, rheumatic heart disease, sick sinus syndrome, Wolff-Parkinson-White syndrome
Chemical / poisoning Carbon monoxide poisoning
Dermatologic No underlying causes
Drug Side Effect Amphetamines, cyclophosphamide, disopyramide, febuxostat, flecainide, Ixabepilone, lacosamide, lithium, orlistat, procainamide, propafenone, quinidine, type Ia antiarrhythmic agents, type Ic antiarrhythmic agents, type III antiarrhythmic agents
Ear Nose Throat No underlying causes
Endocrine Hyperthyroidism, pheochromocytoma, thyrotoxicosis
Environmental No underlying causes
Gastroenterologic Crohn's disease, ulcerative colitis
Genetic Myotonic dystrophy
Hematologic Nonimmune hydrops fetalis
Iatrogenic Cardiac surgery, cardiac transplantation, heart bypass surgery, incomplete ablation procedures, open heart surgery, temporary cardiac pacing
Infectious Disease Amoebiasis, neonatal coxsackie myocarditis, rheumatic fever
Musculoskeletal / Ortho Myotonic dystrophy
Neurologic Subarachnoid hemorrhage
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Atrial myxoma, lung cancer
Opthalmologic No underlying causes
Overdose / Toxicity Alcohol, caffeine, cocaine, digitalis toxicity
Psychiatric Anxiety
Pulmonary Chronic obstructive pulmonary disease, emphysema, hypoxia, lung cancer, obstructive sleep apnea, pneumonia, pulmonary embolism
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy Ankylosing spondylitis, juvenile idiopathic arthritis, psoriatic arthritis, reactive arthritis, sarcoidosis, spondyloarthritis
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Stress

Causes in Alphabetical Order

References

  1. ↑ Gutierrez SD, Earing MG, Singh AK, Tweddell JS, Bartz PJ (2012). "Atrial Tachyarrhythmias and the Cox-maze Procedure in Congenital Heart Disease". Congenit Heart Dis. doi:10.1111/chd.12031. PMID 23280242. Unknown parameter |month= ignored (help)
  2. ↑ Granada, J.; Uribe, W.; Chyou, PH.; Maassen, K.; Vierkant, R.; Smith, PN.; Hayes, J.; Eaker, E.; Vidaillet, H. (2000). "Incidence and predictors of atrial flutter in the general population". J Am Coll Cardiol. 36 (7): 2242–6. PMID 11127467. Unknown parameter |month= ignored (help)
  3. ↑ Murali, A.; Balu, K.; Paari, V.; Rajendiran, G. (2011). "Atrial flutter and pericarditis--a rare complication of right lobe amoebic liver abscess". Med J Malaysia. 66 (5): 499–500. PMID 22390111. Unknown parameter |month= ignored (help)
  4. ↑ Fukamizu S, Sakurada H, Hayashi T; et al. (2012). "Macroreentrant Atrial Tachycardia in Patients without Previous Atrial Surgery or Catheter Ablation: Clinical and Electrophysiological Characteristics of Scar-Related Left Atrial Anterior Wall Reentry". J. Cardiovasc. Electrophysiol. doi:10.1111/jce.12059. PMID 23279349. Unknown parameter |month= ignored (help)
  5. ↑ Nevzorov, R.; Ben-Gal, T.; Strasberg, B.; Haim, M. (2012). "Atrial flutter in a post-transplant recipient". Isr Med Assoc J. 14 (7): 448–9. PMID 22953623. Unknown parameter |month= ignored (help)
  6. ↑ FRIEDBERG, CK.; DONOSO, E. (1960). "Arrhythmias and conduction disturbances due to digitalis". Prog Cardiovasc Dis. 2: 408–31. PMID 13825021. Unknown parameter |month= ignored (help)
  7. ↑ JULIAN DG, VALENTINE PA, MILLER GG (1964). "DISTURBANCES OF RATE, RHYTHM AND CONDUCTION IN ACUTE MYOCARDIAL INFARCTION: A PROSPECTIVE STUDY OF 100 CONSECUTIVE UNSELECTED PATIENTS WITH THE AID OF ELECTROCARDIOGRAPHIC MONITORING". Am J Med. 37: 915–27. PMID 14246092.
  8. ↑ Namboodiri N, Stiles MK, Young GD, Sanders P (2012). "Electrophysiological features of atrial flutter in cardiac sarcoidosis: a report of two cases". Indian Pacing Electrophysiol J. 12 (6): 284–9. PMC 3513242. PMID 23233762. Unknown parameter |month= ignored (help)
  9. ↑ Varma, N.; Helms, R.; Benson, DW.; Sanagala, T. (2011). "Congenital sick sinus syndrome with atrial inexcitability and coronary sinus flutter". Circ Arrhythm Electrophysiol. 4 (5): e52–8. doi:10.1161/CIRCEP.111.964213. PMID 22010118. Unknown parameter |month= ignored (help)
  10. ↑ Tolat, A.; Krishnan, S.; Lippman, N.; Dell'Orfano, J.; Berns, E. (2010). "Advanced heart block and atrial flutter in a patient with HLA B27 spondyloarthropathy". Europace. 12 (6): 903–4. doi:10.1093/europace/euq008. PMID 20118489. Unknown parameter |month= ignored (help)

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