Atrial Flutter

Atrial flutter occurs from a reentrant circuit around the tripcuspid valve in the right atrium. It is an organized rhythm that is generally characterized by an atrial rate around 300 bpm, and a heart rate around 150 bpm. It more commonly occurs in a counterclockwise fashion, leading to inverted flutter waves in the inferior leads (II, III, and aVF). Consider 2:1 flutter in any tachycardia with a ventricular rate of 125 to 200 bpm, most commonly close to 150 bpm.



  1.  Link MS. Evaluation and Initial Treatment of Supraventricular Tachycardia. New England Journal of Medicine. 2012;367(15):1438-1448.
  2. Surawicz B, Knilans TK. Chou’s Electrocardiography in Clinical Practice. 6th ed. Elsevier; 2008.