Table of ContentsView AllTable of ContentsSymptomsCausesTypesComplicationsDiagnosisTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Types
Complications
Diagnosis
Treatment
Coping
Also known as a supraventriculararrhythmia, atrial flutter is caused when the upper chambers of the heart (atria) beat regularly but rapidly, while the lower chambers (ventricles) beat regularly but not as quickly. The lack of synchronicity is what defines an atrial flutter.
While atrial flutter itself is usually not life-threatening, it can significantly increase a person’s risk ofstroke.
Atrial flutter is closely related toatrial fibrillationbut is not the same thing.
Ariel Skelley/Blend Images/Getty Images
What Does Atrial Flutter Feel Like?
The atria serve primarily as reservoirs for blood between heart contractions, whereas the ventricles are responsible for pumping the blood to the lungs and the rest of the body
With atrial flutter, the rapid beating of the upper chambers reduces the amount of oxygen-rich blood delivered to tissues, causing:
Symptoms of atrial flutter tend to come and go suddenly and without warning. Episodes may last for minutes in some people but may persist for days or months in others.
Cardiac arrhythmias like atrial flutter are classified asparoxysmalif they last less than seven days or persistent if they last for more than seven days.
What Causes Atrial Flutter?
Atrial flutter occurs when nerves that cause contractions of the upper chambers of the heart become “trapped” due to a heart injury, surgery, or disease-related changes to the heart muscle.
This interferes with the normal delivery of electrical impulses to the atria. As a result of the looping, the atria will beat rapidly—usually around 250 beats per minute—and occasionally skip a beat.
While anyone can develop atrial flutter, it is much less common than atrial fibrillation. Risk factors for atrial flutter are the same as those for atrial fibrillation, including:
Types of Atrial Flutter
Complications of Atrial Flutter
Left untreated, people with atrial flutter will often experience a progression in the form ofatrial fibrillation, the most common type of cardiac arrhythmia.
Other potentially serious complications of untreated or undertreated atrial flutters include:
Stroke
One of the more worrying concerns about atrial flutter is that increases therisk of stroke. This is because erratic heartbeats can leave blood pooling in the upper chambers of the heart.
This can lead to the formation of aclot, which can then be pumped into the bloodstream and become lodged in an artery of the brain, leading to a type of stroke known as anischemic stroke.
Heart Failure
Atrial flutter can also cause the worsening of symptoms in people withheart failure. This is a condition in which the heart is less able to pump enough blood to support the body’s needs.
Episodes of arrhythmia can further deprive tissues of oxygen, leading to dizziness, fatigue, shortness of breath, and the accumulation of fluid in the lower legs and feet (edema).
Diagnosing Atrial Flutter
The diagnosis of atrial flutter starts with the detection of arrhythmia on anelectrocardiogram (ECG), which records the pattern of electrical activity during a heartbeat.
For atrial flutters, the heart specialist will look for what is called “flutter waves.” Flutter waves look like a sawtooth pattern (called P waves) between larger spikes (called R waves). What distinguishes atrial flutter is that the P and R waves well regularly spaced and sized.
In addition to ECG, anechocardiogramis typically used in people newly diagnosed with atrial flutters. The specialized form ofultrasounduses high-frequency sound waves to generate highly detailed images of the heart muscle and valves.
An echocardiogram can help detect medical conditions that might affect treatment decisions, such asheart valve disordersor the presence of clots.
Atrial Flutter vs. Atrial Fibrillation
With AFib, the atria will beat rapidly and irregularly. With atrial flutter, the atria will beat regularly but faster and more often than the ventricles, with three to four atrial beats to every one ventricular beat.
The difference between atrial flutters and AFib is more clearly seen on ECG. With AFib, there may be no visible P waves or the P waves may look coarse.
What Is the Best Treatment for Atrial Flutter?
The goals of treatment for atrial flutter are to normalize your heart rate, reduce the risk of heart failure or stroke, and relieve any symptoms you may be experiencing.
Several treatment options can be used to stop an acute episode, prevent the recurrence of symptoms, or resolve the condition completely.
Stopping an Acute Episode
During an acute episode, atrial flutter may require treatment in a hospital or emergency department. This is especially true for people with a structural heart problem, like heart valve disease or ventricular hypertrophy.
Severe acute episodes can be stopped with two methods:
Management of Atrial Flutters
Once an acute episode has been treated, medications will be prescribed to prevent recurrence and complications. A combination of drugs is typically prescribed to help normalize the heart rhythm, normalize the heart rate, and prevent blood clots and stroke.
For heart rhythm control, oral antiarrhythmic drugs would be prescribed, including:
For heart rate control, different classes of oral drugs may be prescribed, including:
Toprevent blood clots and strokes, the followinganticoagulants(“blood thinners”) may be prescribed:
Curing Atrial Flutters
The procedure is broadly described as follows:
When used appropriately, the success rate of cardiac catheterization is between 90% and 95%. Even so, it can return in 4% to 6% of people.
Living With Atrial Flutters
Atrial flutters require more than medication; it requires lifestyle changes to avoid complications and recurrence.
Some of the more important interventions include:
Even if you undergo catheter ablation, these interventions can help lower your risk of other heart diseases, likeatherosclerosisand coronary artery disease.
Summary
Atrial flutters are diagnosed with an ECG to show the electrical impulses of your heart. Treatment may include antiarrhythmic drugs, calcium blockers, and beta blockers. Prevention may also involve treating underlying causes, such as hyperthyroidism, sleep apnea, or obesity, or using ablation therapy.
9 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.Heidenreich P, Estes III M, Fonarow G, et al.2020 updated to the 2016 ACC/AHA clinical performance and quality measures for adults with atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures.Circulation. 2021 Jan;14(1):e000100. doi:10.1161/HCQ.0000000000000100National Heart, Lung, and Blood Institute.The heart.Cedars Sinai.Atrial flutter.Brugada J, Katritsis DG, Arbelo E, et al.2019 ESC guidelines for the management of patients with supraventricular tachycardia.Eur Heart J. 2020 Feb;41(5):655-720. doi:10.1093/eurheartj/ehz467Cosio FG.Atrial flutter, typical and typical: a review.Arrhythm Electrophysiol Rev.2017 Jun;6(2):55–62. doi:10.15420/aer.2017.5.2University of New Mexico.Atrial flutter and atrial fibrillation.Charitakis E, Metelli S, Karlsson LO, et al.Comparing efficacy and safety in catheter ablation strategies for atrial fibrillation: a network meta-analysis.BMCMed.2022;20:193. doi:10.1186/s12916-022-02385-2Ali Sabzwari SR, Garg L, Lakkireddy D, Day J.Ten lifestyle modification approaches to treat atrial fibrillation.Cureus.2018 May;10(5):e2682. doi:10.7759/cureus.2682Shamloo AS, Arya A, Dagres N, Hindrick G.Exercise and atrial fibrillation: some good news and some bad news.Galen Med J.2018;7:e1401. doi:10.22086/gmj.v0i0.1401
9 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.Heidenreich P, Estes III M, Fonarow G, et al.2020 updated to the 2016 ACC/AHA clinical performance and quality measures for adults with atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures.Circulation. 2021 Jan;14(1):e000100. doi:10.1161/HCQ.0000000000000100National Heart, Lung, and Blood Institute.The heart.Cedars Sinai.Atrial flutter.Brugada J, Katritsis DG, Arbelo E, et al.2019 ESC guidelines for the management of patients with supraventricular tachycardia.Eur Heart J. 2020 Feb;41(5):655-720. doi:10.1093/eurheartj/ehz467Cosio FG.Atrial flutter, typical and typical: a review.Arrhythm Electrophysiol Rev.2017 Jun;6(2):55–62. doi:10.15420/aer.2017.5.2University of New Mexico.Atrial flutter and atrial fibrillation.Charitakis E, Metelli S, Karlsson LO, et al.Comparing efficacy and safety in catheter ablation strategies for atrial fibrillation: a network meta-analysis.BMCMed.2022;20:193. doi:10.1186/s12916-022-02385-2Ali Sabzwari SR, Garg L, Lakkireddy D, Day J.Ten lifestyle modification approaches to treat atrial fibrillation.Cureus.2018 May;10(5):e2682. doi:10.7759/cureus.2682Shamloo AS, Arya A, Dagres N, Hindrick G.Exercise and atrial fibrillation: some good news and some bad news.Galen Med J.2018;7:e1401. doi:10.22086/gmj.v0i0.1401
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.
Heidenreich P, Estes III M, Fonarow G, et al.2020 updated to the 2016 ACC/AHA clinical performance and quality measures for adults with atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures.Circulation. 2021 Jan;14(1):e000100. doi:10.1161/HCQ.0000000000000100National Heart, Lung, and Blood Institute.The heart.Cedars Sinai.Atrial flutter.Brugada J, Katritsis DG, Arbelo E, et al.2019 ESC guidelines for the management of patients with supraventricular tachycardia.Eur Heart J. 2020 Feb;41(5):655-720. doi:10.1093/eurheartj/ehz467Cosio FG.Atrial flutter, typical and typical: a review.Arrhythm Electrophysiol Rev.2017 Jun;6(2):55–62. doi:10.15420/aer.2017.5.2University of New Mexico.Atrial flutter and atrial fibrillation.Charitakis E, Metelli S, Karlsson LO, et al.Comparing efficacy and safety in catheter ablation strategies for atrial fibrillation: a network meta-analysis.BMCMed.2022;20:193. doi:10.1186/s12916-022-02385-2Ali Sabzwari SR, Garg L, Lakkireddy D, Day J.Ten lifestyle modification approaches to treat atrial fibrillation.Cureus.2018 May;10(5):e2682. doi:10.7759/cureus.2682Shamloo AS, Arya A, Dagres N, Hindrick G.Exercise and atrial fibrillation: some good news and some bad news.Galen Med J.2018;7:e1401. doi:10.22086/gmj.v0i0.1401
Heidenreich P, Estes III M, Fonarow G, et al.2020 updated to the 2016 ACC/AHA clinical performance and quality measures for adults with atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures.Circulation. 2021 Jan;14(1):e000100. doi:10.1161/HCQ.0000000000000100
National Heart, Lung, and Blood Institute.The heart.
Cedars Sinai.Atrial flutter.
Brugada J, Katritsis DG, Arbelo E, et al.2019 ESC guidelines for the management of patients with supraventricular tachycardia.Eur Heart J. 2020 Feb;41(5):655-720. doi:10.1093/eurheartj/ehz467
Cosio FG.Atrial flutter, typical and typical: a review.Arrhythm Electrophysiol Rev.2017 Jun;6(2):55–62. doi:10.15420/aer.2017.5.2
University of New Mexico.Atrial flutter and atrial fibrillation.
Charitakis E, Metelli S, Karlsson LO, et al.Comparing efficacy and safety in catheter ablation strategies for atrial fibrillation: a network meta-analysis.BMCMed.2022;20:193. doi:10.1186/s12916-022-02385-2
Ali Sabzwari SR, Garg L, Lakkireddy D, Day J.Ten lifestyle modification approaches to treat atrial fibrillation.Cureus.2018 May;10(5):e2682. doi:10.7759/cureus.2682
Shamloo AS, Arya A, Dagres N, Hindrick G.Exercise and atrial fibrillation: some good news and some bad news.Galen Med J.2018;7:e1401. doi:10.22086/gmj.v0i0.1401
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