TY - JOUR T1 - FLutter waves in a dialysis patient AU - Tanawuttiwat T, Mitrani RD Y1 - 2011/10/10 N1 - 10.1001/archinternmed.2011.462 JO - Archives of Internal Medicine SP - 1622 EP - 1622 VL - 171 IS - 18 N2 - A 59-year-old African American morbidly obese woman with a medical history of ischemic cardiomyopathy (ejection fraction of 35%), hypertension, diabetes, chronic kidney disease, and obstructive sleep apnea presented with worsening shortness of breath. Her initial physical examination revealed a blood pressure of 83/62 mm Hg, heart rate of 69/min, jugular venous distension, bilateral pulmonary rales, and anasarca. She was diagnosed as having acute decompensated heart failure and was treated with aggressive diuresis. Despite the improvement of her respiratory status and blood pressure, her renal function deteriorated. She eventually required continuous venovenous hemodialysis (CVVHD). Subsequently, 24-hour electrocardiogram (ECG) telemetry monitoring and 12-lead ECG appeared to show new-onset atrial flutter (Figure 1). SN - 0003-9926 M3 - doi: 10.1001/archinternmed.2011.462 UR - http://dx.doi.org/10.1001/archinternmed.2011.462 ER -