Atrial flutter (AFL) is a type of abnormal heart rate, or arrhythmia. It occurs when the upper chambers of your heart beat too fast. When the chambers in the top of your heart (atria) beat faster than the bottom ones (ventricles), it complicates your heart rhythm.
Your heart is controlled by a natural pacemaker (the sinus node), which is located in the right atrium. It sends out electrical signals to both the right and left atria. Those signals tell the top of the heart how and when to contract.
When you have AFL, the sinus node sends out the electrical signal but part of the signal travels along a pathway in a circular motion or circuit around the right atrium, in a continuous loop. This makes the atria contract rapidly, which causes the atria to beat faster than the ventricles. A normal heart bate is 60 to 100 beats per minute (bpm). People with AFL have hearts that beat at 250 to 300 bpm.
Several things can cause AFL.
Coronary Artery Disease
Heart disease is a major cause of AFL. Coronary artery disease occurs when the arteries of the heart become blocked by plaque. Cholesterol and fats that stick to the artery walls cause plaque. This slows or prevents blood circulation. It can damage the heart’s muscle, chambers, and blood vessels.
Open-heart surgery may scar the heart. This can obstruct electrical signals.
Stress raises your heart rate, and results in AFL. You can fix this problem by reducing or eliminating stress.
Risk factors for AFL include certain medications, existing conditions, and lifestyle choices. People who are at risk for atrial flutter tend to:
- have heart disease
- have high blood pressure
- have heart valve conditions
- have lung disease
- have stress or anxiety problems
- take diet pills or certain other medications
Typically, a person with AFL isn’t able to feel the fluttering of their heart. Symptoms and indicators often manifest in other ways. Not every person with AFL will have all the symptoms of the condition, but some include:
- fast heart rate
- shortness of breath
- feeling lightheaded or faint
- pressure in the chest
The symptoms of AFL are common in many other conditions. Having one or more of these symptoms is not always a sign of AFL.
Symptoms often last for days, or even weeks, at a time.
Doctors start to suspect AFL if your heartbeat at rest goes above 100 bpm.
Your family history is important when your doctor is trying to diagnose AFL. A history of heart disease, anxiety issues, and high blood pressure can all affect your risk.
Your primary care doctor can diagnose AFL. You may also be referred to a cardiologist for testing.
Several tests are used to diagnose and confirm AFL.
- Echocardiograms use ultrasound to measure the flow of blood through your heart and blood vessels.
- Electrocardiograms record the electrical patterns of your heart.
- EP (electrophysiology) studies are a more invasive way to record heart rhythm. A catheter is threaded from the arteries of your groin all the way into your heart. Electrodes are then inserted to monitor heart rhythm in different areas.
Your doctor’s main goal is to restore your heart rhythm to normal. Treatment depends on how severe your condition is. Other underlying health problems can also affect AFL treatment.
Medications can be used to slow or regulate your heart rate. Certain medications may require a brief hospital stay while your body adjusts.
Blood thinners can be used to prevent clot formation in your arteries. Clotting can cause a stroke or heart attack. People with AFL have an increased risk of blood clots.
Ablation therapy is used when AFL can’t be controlled through medication. It destroys the heart tissue that’s causing the abnormal rhythm. You may need a pacemaker after this surgery to control your heartbeat.
A pacemaker can also be used without ablation.
Cardioversion uses electricity to shock the heart’s rhythm back to normal. It’s also called defibrillation. Paddles or patches applied to the chest are used to induce the shock.
Medication is often successful in treating AFL. However, the condition can sometimes reoccur. You can reduce the risk of recurrence by reducing your stress and taking your medications as prescribed.