What is the primary treatment approach for stable atrial flutter?

The primary treatment approach for stable atrial flutter focuses on controlling the heart rate effectively. In this context, using beta-blockers or calcium channel blockers is an appropriate strategy. These medications work by slowing down the conduction through the atrioventricular (AV) node, which in turn helps to manage the ventricular response rate during atrial flutter.

This rate control is vital in stable patients who do not present with severe symptoms or hemodynamic instability. By maintaining a controlled heart rate, the risk of developing complications associated with a rapid heart rate, such as tachycardia-induced cardiomyopathy, can be minimized.

Synchronized cardioversion is typically reserved for unstable patients or when there are significant symptoms, such as heart failure or syncope, caused by the arrhythmia. Similarly, antiarrhythmic medications like amiodarone can be used but are not the first step in managing a stable patient. Digoxin may help with rate control, but it is not the preferred initial choice in the acute setting for atrial flutter, particularly because its onset of action is slower and may not adequately stabilize the rapid heart rate. Thus, focusing on rate control with beta-blockers or calcium channel blockers is the most appropriate initial management in stable