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Palpitations caused by typical atrial flutter

I was referred a patient who suddenly developed palpitations and had to be admitted. ECG showed typical atrial flutter at a rate of 132bpm - the characteristic saw-tooth appearance was seen. In this condition, the atria beat at a rate of almost 300bpm due to a short-circuit in the heart. Fortunately, the heart does not beat at this rate as it is slowed down by the AV node. Medications had to be given to further rate-control the atrial flutter.

The patient was advised to get curative treatment and subsequently underwent successful ablation of the cavo-tricuspid isthmus. This procedure was done under local anaesthetic with mild sedation, and the patient was discharged the next day. On review in clinic, he remained free of arrhythmia and was back in normal sinus rhythm.

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