Atrial flutter usually occurs with some degree of A-V block; however, uncommonly it occurs without A-V block, i. e., with 1: 1 A-V conduction. This is an infrequent arrhythmia and is regarded as the most rapid form of tachycardia known to occur in the adult.2 It is a prostrating event because of the extreme rapidity of the heart beat. Ventricular rates up to 320 beats per minute have been reported.2 In at least two instances death has occurred following such paroxysms.3,26 Although this disorder occurs infrequently, as judged by the paucity of its report in the literature,26 it has the potentiality of occurring more frequently through the use of cardiodepressant drugs, such as quinidine.
In 1915 Lewis published the first electrocardiographic tracing of atrial flutter with 1: 1 A-V conduction of a patient with a ventricular rate of 270 beats per minute.1 Approximately 46 additional
MARKS J. Atrial Flutter with 1:1 A-V Conduction. AMA Arch Intern Med. 1957;100(6):989-993. doi:10.1001/archinte.1957.00260120133016