Atrial Flutter

What Is Atrial Flutter?

Atrial flutter is a type of abnormal heart rhythm (arrhythmia) that occurs when the upper chambers (atria) of the heart beat too quickly, fluttering instead of fully squeezing. Atrial flutter can lead to stroke and heart failure.

Atrial Flutter Symptoms

Atrial flutter doesn’t cause symptoms in everyone. For some, symptoms can include:

• Rapid and/or irregular heartbeat
• Shortness of breath
• Dizziness
• Fatigue
• Heart palpitations
• Chest pain
• Lightheadedness
• Passing out

What Causes Atrial Flutter?

Atrial flutter occurs due to changes in the heart’s electrical system. Certain medical conditions and heart surgeries can change how electrical signals travel through the heart to cause atrial flutter.

Cause of atrial flutter include:

• Heart valve disorders
• Congenital heart conditions (present at birth)
• Coronary artery disease
• Heart failure
• High blood pressure
• Overactive thyroid

Atrial Flutter Diagnosis

To diagnose atrial flutter, your healthcare provider will perform a physical exam, including checking your blood pressure, and ask you about your family history. Your doctor may recommend additional tests, including:

• Electrocardiogram (ECG or EKG): A diagnostic tool that records your heart’s electrical activity on a graph.
• Echocardiogram: Uses sound waves to create a moving picture of your heart. In addition to showing the structure of the heart and its valves, this test can reveal areas of poor blood flow in the heart.
• Blood tests: Can be ordered to check for an overactive thyroid gland, electrolyte imbalance or other issues that can cause atrial flutter.
• Exercise stress test: Involves walking on a treadmill or pedaling on a stationary bike while your heart activity is monitored. The test shows how the heart reacts to exercise. Sometimes an echocardiogram is performed as part of a stress test.
• Computed tomography (CT) scan: Your doctor may order a CT scan of the lungs to check for blood clots, which sometimes cause atrial flutter.
• Electrophysiological (EP) study: In this test, your doctor guides one or more flexible tubes (catheters) through a blood vessel to different areas of your heart. Sensors at the tips of the catheters record the heart's electrical signals and can show where incorrect heart signals begin.

Atrial Flutter Treatment

Atrial flutter is often managed by treating the condition that caused it. Atrial flutter can also be treated with medication or a heart procedure.

Medication

Medication helps many people with atrial flutter. Medications can have side effects, but the benefits are usually greater than the risks. Medications used to treat atrial flutter include:

• Calcium channel blockers and beta-blockers that slow down your heart rate.
• Antiarrhythmic drugs that stop the abnormal heart rhythms.
• Anticoagulants that prevent blood clots.

Procedures

If medications aren’t enough to manage atrial flutter, your doctor may recommend one of the following procedures:

• Electrical cardioversion: This treatment is generally used for people who have unstable atrial flutter. Patches or paddles are placed on the chest to send electric shocks to the heart to reset its rhythm. Following the procedure, you may need to take medicine to control your heart rhythm for the rest of your life.
• Pharmacologic cardioversion: Medicines given through an IV or orally are used to reset the heart rhythm.
• Atrial flutter ablation: A type of catheter ablation that helps reset the heart's rhythm. The procedure uses heat (radiofrequency ablation) or extreme cold (cryoablation) to create tiny scars in the heart’s upper chambers to block the faulty electrical signals that cause the abnormal heart rhythm.

If you have atrial flutter and you have a pacemaker or implantable cardioverter defibrillator (ICD), a temporary change in the device’s settings may help fix or manage the condition.