High reversion of atrial flutter to sinus rhythm after atrial pacing in patients with pulmonary disease

The effect of atrial pacing on atrial flutter was evaluated in 36 consecutive episodes in 33 patients. Seventeen episodes occurred in a pulmonary setting, 14 of these in patients with chronic pulmonary disease. Twenty-four (67 percent) of the 36 episodes converted to sinus rhythm within one minute after atrial pacing. In nine (25 percent) of the 36 episodes, atrial fibrillation developed after atrial pacing. Atrial flutter was not affected by atrial pacing in three (8 percent) of the 36 episodes.n 12 (86 percent) of the 14 patients with chronic pulmonary disease and in 14 (82 percent) of the 17 patients in whom a pulmonary setting was responsible for atrial flutter, atrial pacing caused conversion to sinus rhythm. Atrial pacing may be the treatment of choice for atrial flutter in patients with pulmonary disease because of its excellent rate of success in this subgroup whose risk of cardioversion is increased by poor anesthetic tolerance and hypoxia.