Atrial Flutter

What is atrial flutter?

Atrial flutter (AFL) is an abnormal heart rhythm (arrhythmia) where the top chambers of the heart (atria) beat to a fast rhythm. This leads to the contractions of the top chambers of the heart being out of coordination with the lower chambers (ventricles).

People with atrial flutter may experience fast heart rates at rest. A normal resting heart rate is generally between 60 and 100 beats per minute.

What are the symptoms of atrial flutter?

Atrial flutter may cause little to no symptoms. When symptoms are present, they may include:

• shortness of breath
• heart palpitations
• chest pain
• tiredness
• lightheadedness
• dizziness

What causes atrial flutter?

Atrial flutter is caused by abnormal electrical activity in the top chambers of the heart. Causes may include:

• older age
• recent heart surgery
• heart failure
• heart valve disorders
• congenital heart disease
• high blood pressure
• coronary artery disease
• an overactive thyroid
• obesity
• obstructive sleep apnea
• diabetes
• lung disease
• alcohol consumption

In some cases, the cause of atrial flutter may not be clear.

What is the difference between atrial flutter and atrial fibrillation?

Atrial flutter and atrial fibrillation are both arrhythmias of the top chambers of the heart, and frequently occur in the same person. In atrial flutter, the atria beat quickly, but in a regular fashion. In atrial fibrillation, the atria beat chaotically. Atrial fibrillation will generally cause a fast heartbeat, but this is not always the case.

How is atrial flutter diagnosed?

Diagnosis of atrial flutter involves recording the heart’s electrical activity. This may be done through:

• electrocardiography (ECG)
• 24-hour Holter monitor
• event monitoring, which records the heart’s electrical activity over days or weeks

How is atrial flutter treated?

Some episodes of atrial flutter are short-lived and do not require treatment. For persistent or recurring atrial flutter, treatment may include:

• medications e.g. anti-arrhythmic medications to control the heart rhythm and blood thinners to prevent blood clots
• electrical resetting of the heart rhythm (cardioversion)
• procedures to modify the electrical signals in the heart (catheter ablation)
• treatment of any underlying conditions

How can atrial flutter be prevented?

You can reduce your risk of atrial flutter by addressing the associated risk factors. This may include:

• managing your weight
• limiting your alcohol intake
• managing blood pressure
• seeking treatment for conditions such as diabetes