Atrial Flutter

Written by Brindles Lee Macon and Elizabeth Boskey, PhD | Published on August 16, 2012
Medically Reviewed by George Krucik, MD

Overview

Atrial flutter (AFL) is a type of abnormal heart rate, or arrhythmia. It occurs when the upper chambers of your heart (the atria) beat too fast. When the top of your heart (atria) beats faster than the bottom (ventricles), it complicates your heart rhythm.

What Causes Atrial Flutter?

Your heart is controlled by a natural pacemaker (called the sinus node) that is found in the right atrium. It sends out signals to both the right and left atria. Those signals tell the top of the heart (atria) how and when to contract.

When you have AFL, the atria send signals that overwhelm the sinus node. This makes them contract rapidly. The lower chambers respond by also beating very rapidly. A normal heart bate is 60-100 beats per minute (bpm). People with AFL have hearts that beat at 250-300) 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

Open-heart surgery may scar the heart. This can obstruct electrical signals.

Stress

Stress raises your heart rate. You can fix this problem by reducing or eliminating stress.

Who Is at Risk For Atrial Flutter?

You are at risk for AFL if you:

  • smoke
  • 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

What Are the Symptoms of Atrial Flutter?

Not every person with AFL will have all the symptoms of the condition. Symptoms include:

  • fast heart rate
  • shortness of breath
  • feeling lightheaded or faint
  • pressure in the chest

The symptoms of AFL are common. Having one or more of these symptoms is not always a sign of AFL.

How Is Atrial Flutter Diagnosed?

Doctors start to suspect AFL once your heartbeat 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 heart specialist for testing. A heart doctor is called a cardiologist.

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.

How Is Atrial Flutter Treated?

Your doctors’ 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

Medications can be used to slow or regulate your heart rate. Some 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.

Surgery

Ablation therapy is used when AFL can’t be controlled through medication. It destroys the heart tissue that is causing the abnormal rhythm. You may need a pacemaker after this surgery to control your heartbeat.

A pacemaker can also be used without ablation.

Alternative Therapies

Cardioversion uses electricity to shock the heart’s rhythm back to normal. It is also called defibrillation. Paddles or patches applied to the chest are used to induce the shock.

What Can be Expected in the Long Term?

Medication is often successful in treating AFL. However, the condition can sometimes reoccur. You can reduce the risk of recurrence by:

  • reducing your stress
  • taking your medications as prescribed
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