The Audible Sounds of Atrial Tachyarrhythmia (Flutter?)

Abstract

A patient with a rapid atrial mechanism (rate approximately 225), categorized as atrial flutter, had audible sounds correlated with the atrial cycle. Second degree heart block was present and the intensity of the sounds increased sequentially during the ventricular diastolic period. Phonocatheter records revealed prominent vibrations related to the atrial cycle in the right atrium, but not in the right ventricle, left atrium, or left ventricle. It is suggested that the flutter sounds represent tension of the atrial wall or the atrioventricular valve at the time of atrial systole and are unrelated to ventricular filling.