Re: can atrial flutter be fatal ? HELP !!
Atrial Flutter does not kill...except in rare cases. Atrial Flutter has a certain conduction rate. Atrial Flutter occurs when a cell within the Atria (upper chambers of your heart) starts to fire electrical impulses very quickly, ususually at 300bpm or more. You have what is know as the Atrioventricular Node (AV NODE) ... This works as a gate... these elctrical signals are blasting off at 300bpm, but that AV node may have a 2:1 conduction..if this is the case... the atria may be going 300 bpm, while the lower chambers of the heart (the ventricles) are going 150 ... 2:1 means that for every 2 beats the atria fires, the ventricles recieve 1. This is good... If the ventricles were to go that fast then you would have a high pulse... but you obviously have a conduction block in the AV node... The ventricles are the pumping chambers of the heart..and at rates above 240, they cannot properly fill and empty with blood between contractions.. The atria can go as fast as they want with no serious problems, because they are not the main pumping chambers of the heart.. And this is what happens in Atrial Flutter, The upper chambers go so fast, they basically flutter. While the AV node most the electrical signals from reach the ventricles, so the ventricles go at a much slower rate... you have a 2:1 conduction, 3:1, 4:1, or 5:1 ..sometimes it can vary and you can have a mix of all of them
Atrial flutter can become fatal in one of two cases.
A. The person has a rare event with 1:1 conduction..every signal reaches the ventricles and they attempt to contract at the same rate as the atria..usually 300bpm+ ... Blood can no longer be pumped and it comes to a standstill.. Death follows unless medication or cardioversion is given.
B. The person has a medical conditon known as Wolff(Wolfe) Parkinson White Syndrome... It's when a extra pathway, besides the AV node, leads to the Ventricles..Atrial Flutter bypasses and goes down BOTH pathways, usually a high rate (300bpm+) and cardiac arrest (vventricular fibrillation) can follow with death.. WPW occurs in about 2-9 people per 10,000 ... so it's rare. 1:1 conduction that I talked about there is EXTREMELY rare.
Atrial Flutter has never been considered a lethal dysarrythmia... there are ocasional documented cases where it has lead to death or cardiac arrest.. but it's very uncommon.... And there is no risk in doing the vagal stimulation.. If you feel uncomfortable doing it..try other methods... bare down like you would for a bowel movement, splash cold water on your face...or relax, breath is for 4 seconds, hold for 4 seconds, and breath out for 8..... If you cannot termiante the episode, the ER usually can quickly with medication.. if not, the patient may be put to sleep so they can apply a cardioversion (slight shock to the chest) which puts you right back into normal rhythm...