Atrial Heart Sounds in Atrial Fibrillation and Fluttter

Audible atrial contractions were recorded in a case of rheumatic heart disease during atrial fibrillation and the transition stage to atrial flutter. With coarse atrial fibrillation these correlated only roughly with the electrocardiogram, and appeared to have a regularity not always apparent on the electrocardiogram.

In atrial flutter, the atrial contraction sounds were synchronous with the “f” waves. The intensity, quality, and occurrence of the atrial sounds during ventricular systole suggest an extracardiac origin.