Master ECG: Atrial Flutter with Picmonic for Nursing RN

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ECG: Atrial Flutter

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ECG: Atrial Flutter

ECG with Atrial Butterflies
Atrial flutter is an atrial tachydysrhythmia that originates from a single ectopic point in one of the atria. The rate is variable with the atria ranging between 250 to 350 bpm while the ventricles vary greater or less than 100 bpm. The rhythm may be regular or irregular. The presence of multiple P waves before every QRS creates a saw tooth-shaped pattern. Atrial flutter is associated with certain conditions such as, CAD, mitral valve problems, PE, COPD, cor pulmonale, cardiomyopathy, and hyperthyroidism. Medications to treat atrial flutter include amiodarone, calcium channel blockers, beta adrenergic blockers, digoxin, and ibutilide. Cardioversion and ablation may also be indicated to alleviate symptoms of atrial flutter.
Variable Heart-timer

In atrial flutter, the atrial rate varies between 200-350 bpm. The ventricular rate, based on the conduction rate, is approximately 100 bpm.

Regular or Irregular
Regular and Irregular Rhythm-drums

Although atrial rhythm is regular, ventricular rate may be irregular in individuals with atrial flutter.

Saw Tooth, Multiple Before Every QRS
Multiple Saw Teeth before QRS

In atrial flutter, the presence of multiple P waves before every QRS creates a saw tooth-shaped pattern. The flutter waves represent atrial depolarization and repolarization.


In atrial flutter, the PR intervals are variable and non-measurable.

< 0.12 seconds
Less-than 0.12

Like normal sinus rhythm, the QRS interval of individuals with atrial flutter is less than 0.12 seconds.


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