Atrial flutter

What is atrial flutter?

Atrial flutter is an abnormal heart rhythm which occurs when the top chambers of the heart beat rapidly.  As opposed to atrial fibrillation, the top chambers are beating in an organized and regular manner in atrial flutter.  These top chambers typically beat at 300 beats per minute during atrial flutter.  This abnormal rhythm may last for seconds, hours, or days.  It can also become a permanent condition.  

What are the signs and symptoms of atrial flutter?

Patients may experience a variety of symptoms which can include a sensation of a rapid heart rate, palpitations, fatigue, lightheadedness, fainting, shortness of breath, or chest pain.  Many patients with atrial flutter have no symptoms at all.

What causes atrial flutter?

Atrial flutter is associated with a number of conditions such as hypertension, blood clots in the lungs, inflammation around the heart, blockages in the arteries of the heart, thyroid abnormalities, and infection.  Many patients have no identifiable conditions or causes and this is referred to as idiopathic atrial flutter. 

What are the risks of atrial flutter?

One of the major risks of atrial flutter is the development of blood clot in the heart which can lead to strokes.  The risk of developing a blood clot with atrial flutter is related to the duration of atrial flutter and the presence of other risk factors for stroke such as hypertension, diabetes, congestive heart failure, age, and abnormal heart valves.  This risk of stroke can be reduced with a blood thinner called warfarin.  The other risk of atrial flutter is weakening of the heart if it causes the bottom chambers of the heart to beat rapidly for months or years. 

How is atrial flutter treated?

There are many treatment options available for the treatment of atrial flutter.  The best treatment option for any one individual patient depends upon the frequency of episodes of their atrial flutter, their heart rate during atrial flutter, the severity of their symptoms while in atrial flutter, and their other medical conditions.  There is no single treatment option that is best for every patient.  For some patients, the best treatment option is to allow them to remain in atrial flutter.  The goal for these patients is to ensure that their heart is not beating too rapidly and that they are on blood thinner to blood clot. 
For other patients, it is important that regular rhythm is restored and maintained.  These patients may require a cardioversion, the use of antiarrhythmic medications, or a special procedure called an atrial flutter ablation.  Many of these patients for whom regular rhythm is restored still require to remain on a blood thinner.