Atrial flutter.

Atrial flutter is a specific electrical entity. It has a now well-established mechanism involving a single macro-re-entrant circuit. Whilst many patients with atrial flutter may develop atrial fibrillation, atrial flutter deserves its own recognition and requires specific management. Acute termination by drugs is possible, although adding pacing improves efficacy. Ibutilide is a new intravenous therapy with considerable efficacy by with a risk of torsade de pointes. For long-term control, radiofrequency ablation is gradually supplanting chronic oral antiarrhythmic strategies.