Table of ContentsView AllTable of ContentsThe DifferencesProgressionManagement and Outlook
Table of ContentsView All
View All
Table of Contents
The Differences
Progression
Management and Outlook
Atrial flutterandatrial fibrillation (AFib)are both heartarrhythmias. These conditions cause problems with the way your heart beats. They affect theelectrical signalsthat help your heart beat at a normal rate and rhythm.
Atrial flutter and AFib force your atria (the upper chambers of your heart) to contract and push blood into the bottom chambers (ventricles) faster. In atrial flutter, the atria beat at a faster but normal rate. In AFib, the atria beat at a faster but chaotic rate.
Both problems increase your risk of stroke. While they have common symptoms, atrial flutter is less common than AFib.
This article describes how atrial flutter and AFib differ and how they are the same. It includes symptoms, causes, treatment, and long-term outlook.
Justin Paget / Getty Images
Atrial Flutter vs. Atrial Fibrillation: Arrhythmia Differences
Atrial flutter vs. AFib arrhythmia differences involve the way they impact yournormal heart rhythm, as follows:
Your healthcare team can identify the arrhythmia differences between atrial flutter and AFib in anelectrocardiogram (ECG or EKG). This noninvasive medical test is used to evaluate your heart’s electrical system:
Atrial Flutter
Atrial flutter must be identified using an ECG because it is the only diagnostic tool that can pick up atrial flutter’s regular “flutter waves.” These waves produce a sawtooth pattern showing atrial activation. In typical cases of atrial flutter, the atrial rate is around 300 beats per minute, with a ventricular rate of about 150 beats per minute.
Atrial Fibrillation
With AFib, an ECG shows no “P” waves, which precede atrial contraction and irregular or random QRS complexes (which indicate normal heart rhythm). Instead of P waves, the ECG shows several small waves of differing sizes called “f” waves, or fibrillatory waves. These f waves represent up to 600 stimuli per minute that occur in the atria during an episode of AFib.
Asymptomatic Clues and Symptoms
Asymptomatic atrial flutter can occur even if you have an abnormal heart rate. People with no symptoms or only minor symptoms of atrial flutter often have a controlled heart rate that seems to be working as it should.
Asymptomatic AFib is common in about 33% of people with this condition.There are no symptoms in these cases, and the problem may only be detected during a physical examination or testing for another condition.
Research indicates that asymptomatic AFib is associated with the following characteristics:
Symptoms of atrial flutter are often similar to those experienced in AFib. When they occur, these symptoms include the following:
Causes
Identifying the cause of atrial flutter or AFib is not always possible. In some cases, it is the result of damage to your heart’s electrical system from the following conditions:
In some cases, damage to your heart tissue can contribute to changes in your heart’s electrical system. These changes can include the following:
How to Identify Atrial Fibrillation (AFib)
Atrial Flutter Leading to Atrial Fibrillation
In some people, atrial flutter coexists with AFib (alternating from one to the other). In a study of adult patients in Finland with atrial flutter and atrial fibrillation, the following was reported:
Treatment Differences Between Atrial Flutter vs. Fibrillation
While there are some treatment differences between atrial flutter vs. fibrillation, the goals of treating these conditions include the following:
Factors such as your age, your level of fitness, and other medical conditions are used to create a personalized plan of treatment. This can be achieved through the use of medication, devices, and/or surgery.
Medications
Medication can be used to prevent blood clots, slow your heart rate, or restore your heart’s normal rhythm. The following drugs are commonly used:
Beta-blockers:These medications slow the rate at which your lower heart chambers pump blood through your body:
Anticoagulants:These drugs, also known as blood thinners, prevent blood clot formation or treat an existing blood clot. Drugs in this category include the following:
Calcium channel blockers:These drugs can slow your heart rate and reduce the strength of your heart muscle contractions:
Catheter ablation:Catheter ablation, also known asradiofrequency ablation, is effective in curing more than 90% of typical atrial flutter and up to 70% of people with AFib.
This minimally invasive procedure uses thin electrodes that are threaded up the large veins in your groin. The electrodes deliver radiofrequency, cryotherapy, or laser energy to stimulate your heart so your medical team can locate the source of abnormal electrical tissue causing your arrhythmias.
When the defective area of heart tissue is found, the electrodes deliver radiofrequency energy to make a controlled “burn” inside your heart. This destroys the heart muscle cells at the source of the problem and restores normal heart rhythm.
External cardioversion:Externalcardioversionis the delivery of high-energy shocks through defibrillator pads attached to your chest. For some people, this effect can also be achieved using medication.
Internal cardioversion:Internal cardioversion is infrequently used. It is the delivery of a low-energy electrical shock internally in your heart. It is administered using two catheters inserted in a vein in your groin to your heart and a small electrode pad applied to your chest. Internal cardioversion is typically used when external cardioversion and medications have failed to return your heart rhythm to normal.
How Atrial Fibrillation (AFib) Is Treated
Long-Term Management and Outlook
Lifestyle changes can support the long-term management of these conditions and promote heart health. Lifestyle modifications include the following:
Early diagnosis and treatment can help control your heart rate and rhythm, prevent blood clots, reduce your risk of complications, and help you lead a normal life.
Generally, the following outcomes are typical for these conditions:
Atrial flutter is typically less severe and not life-threatening in its early stages. It also poses a lower stroke risk than AFib.
However, atrial flutter should not be ignored. Over time, atrial flutter can weaken your heart muscle, leading to the following problems:
For most people with atrial flutter, catheter ablation can be curative. If the condition is not cured, medications can often manage your condition.
Without treatment, disease progression can make the problem more serious. People with AFib generally have a 4 times increased risk of mortality (death) compared to people in the general population.
However, most people do not die from AFib but instead succumb to complications of the condition. The problems that contribute to the highest mortality rates include stroke, heart disease, and heart failure.
How Treatment Improves Atrial Fibrillation Life Expectancy
Summary
Atrial flutter and AFib are conditions that cause problems with the way your heart beats. They trigger messages that prevent your heart from having a normal heart rate. While atrial flutter can be cured, AFib remains a lifelong issue.
These problems are linked because atrial flutter often precedes AFib. Some people have both problems at the same time. As a result, they involve many of the same symptoms and treatments.
Early diagnosis and treatment are the best ways to prevent long-term problems and disease progress. Since both problems can occur without symptoms, talk to your healthcare provider about your risk of having atrial flutter or AFib and whether testing is advised.
22 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.British Heart Foundation.Heart matters: What’s the difference between atrial flutter and atrial fibrillation?American Heart Association.What is atrial flutter?UChicago Medicine.Atrial fibrillation vs. atrial flutter.Heart Rhythm Society.Atrial fibrillation (AFib).BMJ Best Practice.Atrial flutter.The University of Nottingham.Cardiology teaching package.Cedars-Sinai.Atrial flutter.Sgreccia D, Manicardi M, Malavasi VL, et al.Comparing outcomes in asymptomatic and symptomatic atrial fibrillation: a systematic review and meta-analysis of 81,462 patients.J Clin Med. 2021;10(17):3979. doi:10.3390/jcm10173979European Society of Cardiology.Stroke history higher in asymptomatic versus symptomatic atrial fibrillation patients.Boriani G, Laroche C, Diemberger I, et al.Asymptomatic atrial fibrillation: clinical correlates, management, and outcomes in the EORP-AF pilot general registry.The American Journal of Medicine. 2015;128(5):509-518.e2. doi:10.1016/j.amjmed.2014.11.026NYU Langone Health.Diagnosing atrial fibrillation & atrial flutter.National Heart, Lung, and Blood Institute.Atrial fibrillation: causes and risk factors.Calkins H.Important differences exist between atrial fibrillation and atrial flutter in atrial remodeling.Journal of the American College of Cardiology. 2020;76(4):389-390.Aro A, Eyob-Fesseha H, Haukka J, et al.How often atrial flutter and atrial fibrillation coexist? Results from a large nationwide ECG-based study.Europace. 2023;25(Suppl 1):euad122.037. doi:10.1093/europace/euad122.037American Heart Association.Atrial fibrillation medications.UCSF Health.Atrial flutter.Pharmacy Times.Living with atrial fibrillation.Joglar JA, Chung MK, Armbruster AL, et al.2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[published correction appears in Circulation. 2024 Jan 2;149(1):e167].Circulation. 2024;149(1):e1-e156. doi:10.1161/CIR.0000000000001193Chung MK, Eckhardt LL, Chen LY, et al.Lifestyle and risk factor modification for reduction of atrial fibrillation: a scientific statement from the American heart association.Circulation. 2020;141(16). doi:10.1161/CIR.0000000000000748Al-Kawaz M, Omran SS, Parikh NS, Elkind MSV, Soliman EZ, Kamel H.Comparative risks of ischemic stroke in atrial flutter versus atrial fibrillation.J Stroke Cerebrovasc Dis. 2018;27(4):839-844. doi:10.1016/j.jstrokecerebrovasdis.2017.10.025Yale Medicine.Atrial flutter.Lee E, Choi EK, Han KD, et al.Mortality and causes of death in patients with atrial fibrillation: A nationwide population-based study.PLoS One. December 26, 2018;13(12):e0209687. doi:10.1371/journal.pone.0209687
22 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.British Heart Foundation.Heart matters: What’s the difference between atrial flutter and atrial fibrillation?American Heart Association.What is atrial flutter?UChicago Medicine.Atrial fibrillation vs. atrial flutter.Heart Rhythm Society.Atrial fibrillation (AFib).BMJ Best Practice.Atrial flutter.The University of Nottingham.Cardiology teaching package.Cedars-Sinai.Atrial flutter.Sgreccia D, Manicardi M, Malavasi VL, et al.Comparing outcomes in asymptomatic and symptomatic atrial fibrillation: a systematic review and meta-analysis of 81,462 patients.J Clin Med. 2021;10(17):3979. doi:10.3390/jcm10173979European Society of Cardiology.Stroke history higher in asymptomatic versus symptomatic atrial fibrillation patients.Boriani G, Laroche C, Diemberger I, et al.Asymptomatic atrial fibrillation: clinical correlates, management, and outcomes in the EORP-AF pilot general registry.The American Journal of Medicine. 2015;128(5):509-518.e2. doi:10.1016/j.amjmed.2014.11.026NYU Langone Health.Diagnosing atrial fibrillation & atrial flutter.National Heart, Lung, and Blood Institute.Atrial fibrillation: causes and risk factors.Calkins H.Important differences exist between atrial fibrillation and atrial flutter in atrial remodeling.Journal of the American College of Cardiology. 2020;76(4):389-390.Aro A, Eyob-Fesseha H, Haukka J, et al.How often atrial flutter and atrial fibrillation coexist? Results from a large nationwide ECG-based study.Europace. 2023;25(Suppl 1):euad122.037. doi:10.1093/europace/euad122.037American Heart Association.Atrial fibrillation medications.UCSF Health.Atrial flutter.Pharmacy Times.Living with atrial fibrillation.Joglar JA, Chung MK, Armbruster AL, et al.2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[published correction appears in Circulation. 2024 Jan 2;149(1):e167].Circulation. 2024;149(1):e1-e156. doi:10.1161/CIR.0000000000001193Chung MK, Eckhardt LL, Chen LY, et al.Lifestyle and risk factor modification for reduction of atrial fibrillation: a scientific statement from the American heart association.Circulation. 2020;141(16). doi:10.1161/CIR.0000000000000748Al-Kawaz M, Omran SS, Parikh NS, Elkind MSV, Soliman EZ, Kamel H.Comparative risks of ischemic stroke in atrial flutter versus atrial fibrillation.J Stroke Cerebrovasc Dis. 2018;27(4):839-844. doi:10.1016/j.jstrokecerebrovasdis.2017.10.025Yale Medicine.Atrial flutter.Lee E, Choi EK, Han KD, et al.Mortality and causes of death in patients with atrial fibrillation: A nationwide population-based study.PLoS One. December 26, 2018;13(12):e0209687. doi:10.1371/journal.pone.0209687
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
British Heart Foundation.Heart matters: What’s the difference between atrial flutter and atrial fibrillation?American Heart Association.What is atrial flutter?UChicago Medicine.Atrial fibrillation vs. atrial flutter.Heart Rhythm Society.Atrial fibrillation (AFib).BMJ Best Practice.Atrial flutter.The University of Nottingham.Cardiology teaching package.Cedars-Sinai.Atrial flutter.Sgreccia D, Manicardi M, Malavasi VL, et al.Comparing outcomes in asymptomatic and symptomatic atrial fibrillation: a systematic review and meta-analysis of 81,462 patients.J Clin Med. 2021;10(17):3979. doi:10.3390/jcm10173979European Society of Cardiology.Stroke history higher in asymptomatic versus symptomatic atrial fibrillation patients.Boriani G, Laroche C, Diemberger I, et al.Asymptomatic atrial fibrillation: clinical correlates, management, and outcomes in the EORP-AF pilot general registry.The American Journal of Medicine. 2015;128(5):509-518.e2. doi:10.1016/j.amjmed.2014.11.026NYU Langone Health.Diagnosing atrial fibrillation & atrial flutter.National Heart, Lung, and Blood Institute.Atrial fibrillation: causes and risk factors.Calkins H.Important differences exist between atrial fibrillation and atrial flutter in atrial remodeling.Journal of the American College of Cardiology. 2020;76(4):389-390.Aro A, Eyob-Fesseha H, Haukka J, et al.How often atrial flutter and atrial fibrillation coexist? Results from a large nationwide ECG-based study.Europace. 2023;25(Suppl 1):euad122.037. doi:10.1093/europace/euad122.037American Heart Association.Atrial fibrillation medications.UCSF Health.Atrial flutter.Pharmacy Times.Living with atrial fibrillation.Joglar JA, Chung MK, Armbruster AL, et al.2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[published correction appears in Circulation. 2024 Jan 2;149(1):e167].Circulation. 2024;149(1):e1-e156. doi:10.1161/CIR.0000000000001193Chung MK, Eckhardt LL, Chen LY, et al.Lifestyle and risk factor modification for reduction of atrial fibrillation: a scientific statement from the American heart association.Circulation. 2020;141(16). doi:10.1161/CIR.0000000000000748Al-Kawaz M, Omran SS, Parikh NS, Elkind MSV, Soliman EZ, Kamel H.Comparative risks of ischemic stroke in atrial flutter versus atrial fibrillation.J Stroke Cerebrovasc Dis. 2018;27(4):839-844. doi:10.1016/j.jstrokecerebrovasdis.2017.10.025Yale Medicine.Atrial flutter.Lee E, Choi EK, Han KD, et al.Mortality and causes of death in patients with atrial fibrillation: A nationwide population-based study.PLoS One. December 26, 2018;13(12):e0209687. doi:10.1371/journal.pone.0209687
British Heart Foundation.Heart matters: What’s the difference between atrial flutter and atrial fibrillation?
American Heart Association.What is atrial flutter?
UChicago Medicine.Atrial fibrillation vs. atrial flutter.
Heart Rhythm Society.Atrial fibrillation (AFib).
BMJ Best Practice.Atrial flutter.
The University of Nottingham.Cardiology teaching package.
Cedars-Sinai.Atrial flutter.
Sgreccia D, Manicardi M, Malavasi VL, et al.Comparing outcomes in asymptomatic and symptomatic atrial fibrillation: a systematic review and meta-analysis of 81,462 patients.J Clin Med. 2021;10(17):3979. doi:10.3390/jcm10173979
European Society of Cardiology.Stroke history higher in asymptomatic versus symptomatic atrial fibrillation patients.
Boriani G, Laroche C, Diemberger I, et al.Asymptomatic atrial fibrillation: clinical correlates, management, and outcomes in the EORP-AF pilot general registry.The American Journal of Medicine. 2015;128(5):509-518.e2. doi:10.1016/j.amjmed.2014.11.026
NYU Langone Health.Diagnosing atrial fibrillation & atrial flutter.
National Heart, Lung, and Blood Institute.Atrial fibrillation: causes and risk factors.
Calkins H.Important differences exist between atrial fibrillation and atrial flutter in atrial remodeling.Journal of the American College of Cardiology. 2020;76(4):389-390.
Aro A, Eyob-Fesseha H, Haukka J, et al.How often atrial flutter and atrial fibrillation coexist? Results from a large nationwide ECG-based study.Europace. 2023;25(Suppl 1):euad122.037. doi:10.1093/europace/euad122.037
American Heart Association.Atrial fibrillation medications.
UCSF Health.Atrial flutter.
Pharmacy Times.Living with atrial fibrillation.
Joglar JA, Chung MK, Armbruster AL, et al.2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[published correction appears in Circulation. 2024 Jan 2;149(1):e167].Circulation. 2024;149(1):e1-e156. doi:10.1161/CIR.0000000000001193
Chung MK, Eckhardt LL, Chen LY, et al.Lifestyle and risk factor modification for reduction of atrial fibrillation: a scientific statement from the American heart association.Circulation. 2020;141(16). doi:10.1161/CIR.0000000000000748
Al-Kawaz M, Omran SS, Parikh NS, Elkind MSV, Soliman EZ, Kamel H.Comparative risks of ischemic stroke in atrial flutter versus atrial fibrillation.J Stroke Cerebrovasc Dis. 2018;27(4):839-844. doi:10.1016/j.jstrokecerebrovasdis.2017.10.025
Yale Medicine.Atrial flutter.
Lee E, Choi EK, Han KD, et al.Mortality and causes of death in patients with atrial fibrillation: A nationwide population-based study.PLoS One. December 26, 2018;13(12):e0209687. doi:10.1371/journal.pone.0209687
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
