Atrial flutter is a fast abnormal beating of the heart. It happens in the upper part of the heart called the atria. These fast beats make it hard for the heart to push blood to the body.
Atrial flutter may be sudden event or comes and go over a long time. It is not often life-threatening when treated. It can increase the risk of blood clots and a stroke.
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Electrical signals control how fast the heart beats. The signals also make sure it beats in a regular rhythm. Flutter happens when these signals fire when they shouldn't or they are blocked. It may happen because of:
- Stimulation from drugs, medical treatment, or caffeine
- Changes to heart muscle caused by other health issues like lung disease
Factors that may increase the chances of atrial flutter:
- Coronary artery disease (CAD)
- Heart surgery
- History of high blood pressure
- Problems of the heart or heart valves such as hypertrophy or mitral valve prolapse
- Thyroid gland issues—hyperthyroidism
- Lung disease such as emphysema or chronic obstructive pulmonary disease (COPD)
- High levels of stress or anxiety
- Frequent use of caffeine, alcohol, diet pills
- Some prescription or over the counter medicince such as cold pills
Atrial flutter is more common in older adults.
Atrial flutter may not be felt. For some, it may cause:
- A fluttering or tremor-like feeling in the chest
- Rapid heart beat or pounding sensation in the chest—palpitations
- Pressure or discomfort in the chest
- Shortness of breath
- Lightheadedness or fainting
The doctor will ask about symptoms and past health. A physical exam will be done. A heart rhythm issue may be suspected. Tests will be run to check the activity of the heart. Tests may include:
The goal of treatment is to return to normal rhythm. It may be needed to restore immediate rhythm. Other steps may prevent the flutter from happening again. Treatment options include:
Medicine can help to slow the heart rate. It may also change the flutter to a normal rhythm. Medicine may include:
- Nonhydropyridine calcium channel antagonists
Antiarrhythmic medicine may be needed long term to keep a normal rhythm.
Atrial flutter may need to be corrected with this procedure. A pad is placed on the chest. It delivers a shock to the heart to get it back to a normal rhythm.
The flutter may be caused by an area of abnormal tissue. Ablation is a procedure to destroy the abnormal tissue. This may allow electrical signals to flow smoother through the heart. It may prevent future flutter.
Atrial flutter may not be completely cured. It may come and go over time. Flutter can cause some pooling of blood in the upper heart. Blood clots can form in the pool. Clots that travel out of the heart can travel to the brain and cause a stroke. Blood thinners medicine may be given to reduce the risk of a blood clots.
To reduce the risk of some atrial flutter:
- Avoid or limit caffeine, stimulants, alcohol, and nicotine.
- Follow care plan for other heart or lung problems.
- Reduce levels of stress and anxiety
American Heart Association
Heart Rhythm Society
Canadian Heart Rhythm Society
Heart and Stroke Foundation of Canada
Atrial flutter. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115251/Atrial-flutter. Updated October 14, 2019. Accessed October 30, 2019.
Atrial flutter. Heart Rhythm Society website. Available at http://www.hrsonline.org/Patient-Resources/Heart-Diseases-Disorders/Atrial-Flutter#axzz3MHkY4esv. Accessed October 30, 2019.
Other heart rhythm disorders. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/Other-Rhythm-Disorders_UCM_302045_Article.jsp#.Wh2p2VWnFxA. Accessed October 30, 2019.
Last reviewed October 2019 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 10/30/2019