The heart has four chambers. It has two upper chambers (atria) and two lower chambers (ventricles). Electrical signals regulate the heart beat. The signals also help the atria and ventricles work together in the same rhythm. The blood from the atria is pushed into the ventricles and leave the heart to circulate to the rest of the body.
Atrial flutter is a type of abnormal fast beating ( arrhythmia) in the atria. These fast beats make it difficult for the atria to pushing all the blood into the ventricles. As a result, the ventricles push less blood through the body.
Atrial flutter may be an acute or chronic disorder that comes and goes. Atrial flutter is not usually life-threatening when it is treated. However, it may increase your risk of developing blood clots and stroke.
This condition can be treated. Contact your doctor if you think you may have atrial flutter.
Anatomy of the Heart
Atrial flutter may be caused by the following:
- Heart disease
- Heart surgery–atrial flutter is most common during the first few weeks after open-heart surgery
- Disease in other parts of the body that affects the functioning of the heart, such as the lungs
- Using substances such as caffeine, alcohol, diet pills, or certain types of prescription or over-the-counter medication that affect the electrical impulses of the heart
- Stress and anxiety
Risk factors that increase your chance of developing atrial flutter include:
- Heart disease
- Heart surgery
- History of high blood pressure (hypertension)
- Abnormalities of the heart or heart valves (eg, hypertrophy, mitral valve prolapse)
- Overactive thyroid gland ( hyperthyroidism)
- History of chronic lung disease (eg, emphysema, chronic obstructive pulmonary disease)
- High levels of stress or anxiety
- Chronic use of caffeine, alcohol, diet pills, or certain types of prescription or over-the-counter medication (such as cold medicines)
Atrial flutter is more likely to develop in older adults.
If you have any of these symptoms, do not assume the cause is due to atrial flutter. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your physician.
Atrial flutter does not always produce symptoms. However, symptoms, when present, include:
- A fluttering or tremor-like feeling in the chest
- Rapid heart beat or pounding sensation in the chest (palpitations)
- Pressure or discomfort in the chest
- Shortness of breath
- Dizziness or fainting
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may also recommend that you see a cardiologist or arrhythmia specialist. This type of physician may be found in a larger hospital.
Your doctor may need pictures of your heart and information about how it functions. This can be done with:
The goal of treating atrial flutter is to slow down the electrical impulses that are sent from the atria to the ventricles. Treatment aims at restoring normal rhythm and preventing future episodes. Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Pharmacologic (Medication) Therapy
Medication may be given to slow the rapid heart rate and change the atrial flutter to a normal rhythm. These medications may include:
- Beta-blockers (eg, metoprolol)
- Nonhydropyridine calcium channel antagonists (eg, diltiazem, verapamil)
Other medications called antiarrhythmics may be used to change the rhythm back to normal. They may also help your heart maintain a normal rhythm. Some such medications include:
- Sotalol (Betapace)
- Propafenone (Rythmol)
- Flecainide (Tambecor)
- Amiodarone (Cordarone)
- Dofetilide (Tikosyn)
- Ibutilide (Corvert)
An external defibrillator is applied to the chest. It uses electrical current to shock the heart back to its normal rhythm.
Ablation can be performed during an EP study on patients with recurring atrial flutter that cannot be controlled with medications. Using the same catheters, an area of the heart where an abnormal electrical rhythm is generated can be destroyed. This can be a cure for atrial flutter.
Blood thinners (warfarin) are an important therapy to prevent blood clots that can cause strokes or other serious complications. They can be used on patients who have recurrent atrial flutter. They can also be used on those who are at an increased risk.
Follow your doctor's instructions if you are diagnosed with atrial flutter..
Take the following steps to help reduce your chances of getting atrial flutter:
- Reduce or eliminate your use of caffeine, stimulants, alcohol, nicotine, certain medications (eg, cold medicine, diet pills), or recreational drugs
- Obtain treatment for any other heart or lung disease
- Reduce your levels of stress and anxiety
- Check with your doctor before taking any new medications, herbs, or supplements
American Heart Association
Heart Rhythm Society
National Heart, Lung, and Blood Institute
Canadian Cardiovascular Society
Heart and Stroke Foundation of Canada
Atrial flutter. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated October 31, 2012. Accessed November 9, 2012.
Atrial flutter. EBSCO Health Library website. Available at: http:www.ebscohost.com/pointofcare . Updated November 9, 2012. Accessed November 9, 2012.
Atrial flutter. Heart Rhythm Society website. Available at http://www.hrsonline.org/Patient-Resources/Heart-Diseases-Disorders/Atrial-Flutter. Accessed November 9, 2012.
Lee KW, Yang Y, Scheinman MM. Atrial flutter: a review of its history, mechanisms, clinical features, and current therapy. Curr Prob Cardiol. 2005;30(3):121-167.
Last reviewed December 2013 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.