ASA Monitor 04 2017, Vol.81, 56.
A 67-year-old woman with no significant past medical history presents to the emergency department with dyspnea. Her electrocardiogram shows atrial flutter with a ventricular rate of 150 beats/minute. Which of the following would be most effective for pharmacologic cardioversion to sinus rhythm in this patient?
Atrial flutter is a right-sided atrial re-entrant dysrhythmia characterized by a regular, rapid atrial rate of 240 to 400 beats/minute and an atrioventricular nodal block, which may range from 2:1 to 8:1. In patients who are hemodynamically unstable, synchronized cardioversion at 25 to 50 J is very effective at converting atrial flutter to sinus rhythm.