Atrial Gallop

Atrial refers to the upper chamber of the heart and atrial flutter is a very rapid,very regular atrial tachycardia, occurring at rates between 200 and 400 BPM, which typically have no associated isoelectric segments between the atrial complexes. The lack of an isoelectric or baseline segment between the atrial waves, and the smooth, biphasic P wave morphology, gives the atrial baseline a ‘saw-tooth’ appearance on the ECG. That ‘saw-tooth’ appearance is the most distinctive, and unique, feature of atrial flutter.

Firstly when atrial flutter occurs, it is usually associated with a fast heart rate or tachycardia, and falls into the category of supra-ventricular tachycardias. This type of rhythm occurs most often in individuals with cardiovascular disease (eg: hypertension, coronary artery disease, and cardiomyopathy), it may occur spontaneously in people with otherwise normal hearts. It is frequently degenerates into atrial fibrillation and not a stable rhythm. However, it may slowly persist for months to years. Initially Atrial flutter is usually well tolerated (a high heart rate is for most people just a normal response to exercise), however, people who are suffering with other underlying heart disease or poor exercise tolerance may rapidly develop symptoms, which can include shortness of breath, chest pains, lightheadedness or dizziness, nausea and, in some patients, nervousness and feelings of impending doom while this rhythm can sometimes go unnoticed, its onset is often marked by characteristic sensations of regular palpitations. Such sensations usually last until the heart rate is controlled or episode resolves.

Gallop Atrial is the rhythm in which the gallop sound follows atrial systole in late diastole and is an audible fourth heart sound due to forceful ventricular filling. Atrial gallop is type of sound which is frequently frequent found in hypertensive cardiovascular disease, myocardial infarction, and in the presence of a prolonged atrioventricular conduction time.

The main goals of treatment of atrial gallop are to prevent temporary circulatory instability and to prevent stroke. Anticoagulation may be required to decrease the risk of the latter while rate and rhythm control are principally used to achieve the former. When circulatory collapse is imminent in emergency cases due to uncontrolled tachycardia, immediate cardioversion may be indicated. If rate and rhythm control of the atrial gallop cannot be maintained by medication or cardioversion, electrophysiological studies with pathway ablation may be required.