A 67 yo complains of palpitations on day 1 after thyroid surgery. His vitals are stable and his ECG is shown below. What treatment is not useful for treating the below arrhythmia?
a. Beta blocker
b. Antiarrhythmic like ibutilide
c. Calcium channel blocker
d. Adenosine
e. Warfarin
f. Catheter ablation
1. Initiate A-V nodal blockade with ß-adrenergic or calcium channel blockers or procainamide.
2. These medications slow the ventricular response by slowing conduction in the AV node. In general, beta blockers are used for rate control.
3. Overall, atrial flutter should be managed in the same way as atrial fibrillation. Because both rhythms can lead to the formation of a blood clot in the atrium, individuals with atrial flutter usually require some form of anticoagulation or antiplatelet agent.
4. Both rhythms can be associated with dangerously fast heart rates and thus require medication to control the heart rate (such as beta blockers or calcium channel blockers) and/or rhythm control with class III antiarrhythmics (such as ibutilide or dofetilide). However, atrial flutter is more resistant to correction with such medications than atrial fibrillation.
