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The main symptom of AVNRT is the sudden development of rapid regular palpitations. [1] These palpitations may be associated with a fluttering sensation in the neck, caused by near-simultaneous contraction of the atria and ventricles against a closed tricuspid valve leading to the pressure or atrial contraction being transmitted backwards into the venous system. [2]
This is the property of the AV node that prevents rapid conduction to the ventricle in cases of rapid atrial rhythms, such as atrial fibrillation or atrial flutter. The AV node's normal intrinsic firing rate without stimulation (such as that from the SA node) is 40–60 times/minute. [ 13 ]
Atrial flutter is also not necessarily a tachycardia by definition unless the AV node permits a ventricular response greater than 100 beats per minute. AV nodal reentrant tachycardia (AVNRT) involves a reentry circuit forming next to, or within, the AV node. The circuit most often involves two tiny pathways one faster than the other.
Title: Exhibit 43 Author: gshapiro Keywords: None Created Date: 1/13/2010 4:14:22 PM
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John J. Kurz, RMR-CRR, Official Court Reporter Phone 215-683-8035 Fax 215-683-8005 - PLEDGER, et al. -vs- JANSSEN, et al. - 4 1 (Whereupon the Jury resumed
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Atypical atrial flutter rarely occurs in people who have not undergone previous heart surgery or previous catheter ablation procedures. Left atrial flutter is considered atypical and is common after incomplete left atrial ablation procedures. [13] Atypical atrial flutter originating from the right atrium and heart's septum have also been described.