Editor's Correspondence |

Acute Pulmonary Edema After Overdrive for Atrial Flutter

Victor J. Castro, MD
Arch Intern Med. 1998;158(6):679. doi:.
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Upshaw's1 excellent review of hemodynamic changes after cardioversion for atrial fibrillation reports and analyzes the occurrence of acute pulmonary edema after cardioversion of atrial fibrillation. However, pulmonary edema can also complicate reversal of atrial flutter as the following case illustrates.

Upshaw  CB  Jr Hemodynamic changes after cardioversion of chronic atrial fibrillation. Arch Intern Med. 1997;1571070- 1076
Shively  BKGelgand  EACrawpord  MH Regional left atrial stasis during atrial fibrillation and flutter: determinants and relation to stroke. J Am Coll Cardiol. 1996;271722- 1729
Kerr  CRGallagher  JJSmith  WM  et al.  The induction of atrial flutter and fibrillation and the termination of atrial flutter by esophageal pacing. Pacing Clin Electrophysiol. 1983;660- 72
Grimm  RAStewart  WJArheart  KL  et al.  Left atrial appendage ‘stunning' after electrical cardioversion of atrial flutter: an attenuated response compared with atrial fibrillation as the mechanism for lower susceptibility to thromboembolic events. J Am Coll Cardiol. 1997;29582- 589
Wood  KAEisenberg  SJKalman  JM  et al.  Risk of thromboembolism in chronic atrial flutter. Am J Cardiol. 1997;791043- 1047
Harjai  KJMobarek  SKCheirif  J  et al.  Clinical variables affecting recovery of left atrial mechanical function after cardioversion from atrial fibrillation. J Am Coll Cardiol. 1997;30481- 486
Jordaens  LMissault  LGermonpre  E  et al.  Delayed restoration of atrial function after conversion of atrial flutter by pacing or electrical cardioversion. Am J Cardiol. 1993;7163- 67

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