Nº2 of seven Little Etudes for beginner and intermediate piano players based on different cardiac electrophysiology aberrations for day 2 of WHRW2020: World Heart Rhythm Week (1-7 June 2020). Etude Nº2 is based on Atrial Flutter (AFL). Like atrial fibrillation, the abnormal heart rhythms of AFL carries the risk of stroke. It also tends to promote new or more frequent onsets of pre-existing arrhythmias.
In AFL, the upper chambers of the heart, the atria, beat very rapidly at around 300 beats per minute. The heart’s gating mechanism, the atrioventricular (AV) node, cannot conduct at the rapid rate to the lower chambers, the ventricles, and only allows every second, third, or fourth beat through. The resulting heart rate is some simple fraction of 300, i.e. 150, 100, or 75 beats per minute. Combinations of 2:1, 3:1, 4:1 AV block can lead to irregular rhythms. In the ECG (electrographic) trace,
AFL has a characteristic sawtooth appearance. This set of little etudes show AFL with 3:1 block, AFL with 4:1 block, and AFL with variable block. The etudes are first played slowly, and the final one is repeated quickly, at around a 300 bpm note rate.