Atrial flutter

Learn more about this condition in which the heart's upper chambers beat too quickly, causing a rapid, but usually regular, heart rhythm.

Update Date: 29.08.2024

Overview
Symptoms
Causes
Risk factors
Complications
Prevention
Diagnosis
Treatment
Overview
Symptoms
Causes
Risk factors
Complications
Prevention
Diagnosis
Treatment

Overview

Atrial flutter is a type of heart rhythm disorder, called an arrhythmia. It is similar to atrial fibrillation (AFib). But in atrial flutter the heart rhythm is more organized and less chaotic than in AFib. A person can have both atrial flutter and AFib.

Atrial flutter may not cause symptoms. But some people may have a pounding, rapid heartbeat and chest pain. Fainting or almost fainting also may happen. Treatment for atrial flutter may include medicines and a heart procedure.

Atrial flutter

Atrial flutter is a type of heart rhythm disorder. The heart's upper chambers, called the atria, beat too quickly.

Symptoms

People with atrial flutter may not have symptoms. The irregular heartbeat may be found during a health checkup for another reason.

If atrial flutter symptoms happen, they may include:

  • A pounding or racing feeling in the chest.
  • Chest pain.
  • Fainting or almost fainting.
  • Shortness of breath.
  • Feeling very tired.

When to see a doctor

If you feel like your heart is pounding, fluttering, skipping a beat or beating too fast, make an appointment for a health checkup. You may be told to see a doctor trained in heart diseases, called a cardiologist.

Get emergency medical care if you have these symptoms:

  • Chest pain.
  • Shortness of breath.
  • Fainting.

Always call 911 or your local emergency number if you think you might be having a heart attack.

Causes

Changes in the heart's electrical system cause atrial flutter. The heart's electrical system controls the heartbeat. Some health conditions or heart surgery can change how electrical signals travel through the heart and cause atrial flutter.

The movement of the heart's signals make the heart squeeze and pump blood. Usually, this process goes smoothly. The typical resting heart rate is about 60 to 100 beats a minute. But in atrial flutter, the heart's upper chambers beat too quickly. This causes the heart to beat in a fast, but usually organized, way.

Risk factors

Some health conditions increase the risk of atrial flutter. They include:

  • Heart failure.
  • Chronic obstructive pulmonary disease, also called COPD.
  • Blood clot in the lungs, called a pulmonary embolism.
  • Heart condition present at birth, called a congenital heart defect.

Other risk factors for atrial flutter are:

  • Getting older.
  • Recent heart surgery.

Complications

A complication of atrial flutter is atrial fibrillation (AFib). About half of people with atrial flutter get AFib within three years. AFib increases the risk of blood clots and strokes.

Other complications of atrial flutter are:

  • Heart failure.
  • Stroke.
  • Heart attack.

Prevention

Lifestyle changes help keep the heart healthy. Try these heart-healthy tips:

  • Don't smoke.
  • Eat healthy foods such as fruits, vegetables and whole grains. Eat less salt and saturated fats.
  • Exercise at least 30 minutes a day on most days of the week.
  • Keep a healthy weight.
  • Use less or do not use caffeine and alcohol.
  • Reduce and manage stress.
  • Control high blood pressure, high cholesterol and diabetes.
  • Get good sleep. Adults should try to get 7 to 9 hours daily.

Diagnosis

To diagnose atrial flutter, a healthcare professional examines you and listens to your heart. A member of your care team takes your blood pressure. You usually are asked questions about your symptoms, health habits and medical history.

Tests

You may have tests to check your heart and to look for health conditions that can cause an irregular heartbeat. Tests for atrial flutter may include:

  • Lab tests. Blood and urine tests are done to look for health conditions or substances that may affect the heart or heartbeat. If your healthcare team thinks you have atrial flutter, you may have blood tests to check your liver, thyroid and kidneys.
  • Electrocardiogram (ECG or EKG). This quick test checks the electrical activity of the heart. It can show how fast or how slow the heart is beating. Sticky patches called sensors attach to the chest and sometimes to the arms or legs. Wires connect the patches to a computer, which displays or prints results.
  • Holter monitor. This portable ECG device can be worn for a day or more to record the heart's activity during daily activities.
  • Event recorder. This portable ECG device is worn for up to 30 days or until an irregular heartbeat or symptoms occur. You typically press a button when symptoms occur.
  • Implantable loop recorder. If irregular heartbeat symptoms don't happen very often, this device may be placed under the skin in the chest area. The device constantly records the heart's electrical activity. It can find irregular heart rhythms.
  • Echocardiogram. This test uses sound waves to take pictures of the beating heart. It shows the structure of the heart and heart valves. It also shows how blood flows through the heart.
  • Exercise stress tests. These tests often involve walking on a treadmill or pedaling a stationary bike while the heart activity is checked. The tests show how the heart reacts to exercise. If you can't exercise, you may get medicine that increases the heart rate like exercise does. Sometimes an echocardiogram is done during a stress test.
  • CT scan of the lungs. You may need this test to check for a blood clot in the lungs, which may cause atrial flutter.
  • Electrophysiological (EP) study. This test shows where incorrect heart signals start in the heart. A doctor moves one or more flexible tubes through a blood vessel, usually in the groin, to different areas in the heart. Sensors on the tips of the tubes record the heart's electrical signals.

Treatment

Atrial flutter treatment depends on your overall health and how severe your symptoms are. Treatment may involve medicine or a heart procedure.

Medications

If you have atrial flutter, your healthcare professional may give you medicines to:

  • Control the speed of the heartbeat.
  • Restore the heart rhythm.
  • Prevent blood clots if you also have AFib.

Surgeries or other procedures

If medicine doesn't control atrial flutter, a heart doctor may try to reset your heart rhythm using a procedure called cardioversion.

Cardioversion can be done in two ways:

  • Electrical cardioversion. Paddles or patches on the chest send electric shocks to the heart to reset its rhythm. This treatment is commonly used for people with unstable atrial flutter. After electrical cardioversion, you may need medicines to control your heart rhythm for the rest of your life.
  • Pharmacologic cardioversion. Medicines given through a vein or by mouth are used to reset the heart rhythm.

Cardioversion usually is done in a hospital as a scheduled procedure. But it may be done in emergency situations.

Radiofrequency ablation is another treatment for atrial flutter. Your heart doctor may suggest this treatment if you have repeated bouts of atrial flutter. But it may be used at other times. The treatment uses thin, flexible tubes called catheters and heat energy to create tiny scars in the heart. Heart signals can't pass through the scars. So the scars block the faulty electrical signals that cause the irregular heartbeat.

Radiofrequency ablation has been shown to improve health-related quality of life for people with atrial flutter.

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