Echocardiographic demonstration of atrioventricular mechanical contraction in atrial flutter.

We present the case of a 54-year-old patient with no history of heart disease who underwent transesophageal echocardiography (TEE) to rule out the presence of thrombus in the left atrial appendage (LAA) prior to programmed electrical cardioversion for common counterclockwise atrial flutter with 2:1 ventricular response at 150 bpm. The TEE confirmed good biventricular function, no thrombus in LAA, and slight dilatation of both atria. In the mid-esophageal plane we obtained pulsed-wave Doppler echocardiograms of the LAA at 608 (Fig. 1A) showing organized flow with waves 200 ms