Atrial Flutter-Symptoms, Causes & Treatment

Atrial Flutter: Symptoms, Causes, Diagnosis and Treatment

Atrial flutter is a form of rhythmic disorder that occurs when a person’s heart chambers beat faster than the usual rate. In atrial flutter, the upper heart chambers of a person can beat as fast as 250-350 times per minute.

Though it is not as common as atrial fibrillation, it exhibits similar symptoms and causes and needs active medical attention. Thus, it is crucial to understand the causes and symptoms of atrial flutter for early diagnosis and proper treatment. Read ahead for more insight!

What is Atrial Flutter?

Atrial flutter is considered a common form of supraventricular arrhythmia. In this condition, the heart beats at an abnormal rhythm starting from the two upper chambers (atria)

A healthy heart beats 60-100 times a minute, whereas a rapid fluttering in the chest can lead to a heart rate of 250-350 beats per minute. An atrial flutter ECG report characterized this phenomenon by saw-tooth patterns, indicating prominent atrial activation.

What are the Causes of Atrial Flutter?

Atrial flutter happens when irregular electrical impulses in the atria cause the heart to contract rapidly and repeatedly. Many conditions can cause the development of atrial flutter, including:

• High blood pressure (hypertension)
• Coronary artery disease
• Heart valve issues
• Congenital heart defects
• Previous heart surgeries
• Overactive thyroid (hyperthyroidism)
• Excessive use of alcohol or stimulants (like caffeine and certain medications)
• Chronic lung diseases
• Getting older and being male

What are the Symptoms of Atrial Flutter?

Atrial flutter can show up with symptoms ranging from barely noticeable to pretty intense, and some people may not feel anything at all. When symptoms appear, they mostly include:

• A fluttering or thumping feeling in the chest, which many describe as a ‘fluttering heart’
• A fast or irregular heartbeat
• Shortness of breath
• Dizziness or feeling lightheaded
• Fatigue or weakness, particularly during exercise
• Anxiety
• Discomfort or pain in the chest
• In severe cases, fainting or confusion

Atrial flutter may only be detected during a routine check-up or an electrocardiogram (ECG), since not everyone has clear symptoms.

Key Differences: Atrial Flutter vs Atrial Fibrillation

Atrial flutter and atrial fibrillation (AFib) are abnormal heart rhythm; however, they have significant differences, as discussed in the table below:

About one-third to 40% of people with atrial flutter also experience atrial fibrillation at some point. Both conditions increase the risk of stroke and require careful management.

What is the Diagnosis of Atrial Flutter?

When diagnosing atrial flutter, doctors usually start with a physical exam and confirm their findings using an ECG. This test in atrial flutter displays distinctive saw tooth flutter waves, prominent in leads II, III, and aVF, appearing as a rapid succession of sharp, pointed peaks, resembling a jagged line.

The ECG is crucial for distinguishing atrial flutter from other types of arrhythmias and helping to determine the best course of treatment. Some other tests which the doctors may recommend include:

• Holter monitoring (which is a continuous ECG recording)
• Echocardiogram (an ultrasound of the heart)
• Blood tests to assess thyroid function or identify other potential contributing factors.

What is the Treatment for Atrial Flutter?

When treating atrial flutter, the main aim is to normalize your heart rhythm, keep the heart rate steady, and prevent complications like stroke. Here are some of the best strategies to manage it:

1. Medications

• For Rate Control: Doctors usually recommend beta-blockers, calcium channel blockers (like diltiazem or verapamil), and sometimes digoxin to help slow down the heart rate.
• For Rhythm Control: While antiarrhythmic drugs can be an option, they’re not as effective for atrial flutter as they are for atrial fibrillation. So, doctors often look for other alternatives.
• For Anticoagulation: Blood thinners (like warfarin or some newer options) are suggested to reduce the risk of stroke, especially if the arrhythmia persists or if there are other risk factors at play.

2. Electrical Cardioversion

This procedure involves delivering a controlled electric shock to the heart to bring it back to its normal rhythm. It’s particularly effective for atrial flutter and is often used when medications aren’t doing the trick or if the patient is in a critical situation.

3. Catheter Ablation

This minimally invasive procedure uses radiofrequency energy to address and eliminate the small area of heart tissue responsible for the irregular rhythm. Catheter ablation is highly effective for typical atrial flutter, with success rates exceeding 90%, making it a common choice for recurrent cases.

4. Treating Underlying Causes

Managing conditions like hyperthyroidism, high blood pressure, or heart valve disease is crucial for long-term control.

5. Lifestyle Modifications

Making lifestyle changes, such as cutting back on alcohol and caffeine, managing stress, and maintaining a healthy weight, can help prevent recurrences.

What are the Complications of Atrial Flutter?

If not addressed, atrial flutter can lead to some serious issues, such as:

• An increased risk of stroke due to blood clots that are likely to form in the atria
• Heart attack due to prolonged periods of rapid heart rate
• Ongoing fatigue and a decrease in exercise tolerance
• The possibility of the arrhythmia becoming persistent or even progressing to atrial fibrillation

Getting an early diagnosis and the right treatment for atrial flutter, whether through medications, cardioversion, or catheter ablation, can help manage the condition effectively.