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Atrial Flutter

Atrial Flutter

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Overview

Atrial flutter is a type of abnormal heart rhythm or arrhythmia that occurs in the atria, the upper chambers of the heart. It occurs when the heart's electrical systems malfunction. People may remain asymptomatic. However, atrial flutter increases the risk of developing stroke, cardiac arrest, heart failure, and other complications.

Atrial flutter is treated with medicines or surgery such as ablation (scarring small areas of the heart).

Types of Atrial Flutter

Atrial flutter is divided into two types:

  • Paroxysmal atrial flutter:

    This is an episodic type of atrial flutter that may last for hours or days.

  • Persistent atrial flutter:

    This type is incurable and remains permanent.

Atrial Flutter Symptoms

Atrial flutter is asymptomatic in most patients. Some of the symptoms may appear, like:


More severe symptoms present themselves when the patient has underlying cardiac or pulmonary disorders. They are:

Atrial Flutter Causes

Atrial flutter does not have a specific cause. It may occur due to:

  • Drugs that alter the electrical activities of the heart
  • Alcohol consumption
  • Various stimulants include diet pills, cocaine, cold medicines, and caffeine.

Atrial Flutter Diagnosis

To diagnose atrial flutter, assessment of the heart rhythm is essential. Heart rhythm can be recorded by:

  • Blood tests: This is required to assess any underlying medical conditions such as thyroid, diabetes which may lead to atrial flutter.
  • ECG: Electrocardiography is a procedure in which the electrical activities of the heart are recorded. Tiny patches are connected to the machine and placed over several places on the chest.
  • Holter monitoring: continuous monitoring of the heart rhythm can be done using this portable device. It is usually done for 24 -72 hours.
  • External Loop Recorder: When long-term heart functioning readings need recording, event monitoring is advisable. It can be used for a few weeks.
  • Implantable Loop Recorder: If atrial flutter occurs for a few minutes and episodes are on and off, it may get challenging to capture it. Hence, utilising technology for continuous monitoring can aid in recording atrial flutter. For up to three years of heart monitoring, a loop recorder is surgically placed under the skin over the heart.
  • Echocardiography: To confirm any structural heart abnormality.

Atrial Flutter Treatment

Atrial flutter can be controlled with medicines and seldom require a surgical procedure. The main aim is to control heart rate and prevent stroke.

  • Blood thinners may be prescribed to prevent stroke so that no emboli form throughout blood vessels due to irregular heart rhythm.
  • Medication can also help lower the heart rate.
  • Antiarrhythmics may be prescribed to cease an episode or taken daily to prevent atrial flutter altogether.
  • Electrical cardioversion is a procedure that involves placing several patches across the chest and back. Slight currents are sent through these patches (like a shock) to synchronise with the heartbeat. Mostly, this is enough to restore heart rhythm. A combination of antiarrhythmic drugs and electrical cardioversion may help prevent episodes of an atrial flutter from happening for a long time.
  • Cardiac ablation is a catheter-based procedure in which wires are threaded through the vein in the leg to the heart. Now, heat or cold energy is applied to stop the abnormal circuit.

Atrial Flutter Complications

Atrial flutter is initially not life-threatening. However, untreated cases carry an increased risk of clot formation in the heart. Clots in the heart may cause a stroke which can be fatal.

Another complication can be heart failure owing to injured muscles of the heart due to the constant arrhythmic activity.

Atrial Flutter Risk Factors and Prevention

Atrial flutter can be prevented by:

  • Maintaining a healthy lifestyle
  • Regular exercising and eating a well-balanced diet.
  • Avoid the use of tobacco, cocaine and less caffeine
  • Smoking cessation
  • Moderate consumption of alcohol
  • Constant monitoring of blood pressure and diabetes.

Prognosis

The prognosis of patients with atrial flutter is good. In some cases, it may resolve within 24-48 hours on its own. Patients need to be vigilant and consult a doctor at the earliest to prevent any life-threatening complications such as cardiac arrest or stroke.

Reviewed & Updated On

Reviewed by Dr. Arun Kumar Gupta, Associate Director, Cardiac Sciences, Cardiology, Cardiac Electrophysiology-Pacemaker, Interventional Cardiology on 22-May-2023.

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