Definition

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.

Causes

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

Risk Factors

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.

Symptoms

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
• Anxiety
• Lightheadedness or fainting

Diagnosis

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:

• ECG—to show electrical activity of the heart
• Holter monitor—worn for longer period of time to track electrical activity of the heart
• Electrophysiological study (EP)—test of electrical activity of heart

Treatment

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:

Prevention

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