Definition

The heart has four chambers. It has two upper chambers (atria) and two lower chambers (ventricles). Electrical signals regulate the heart beat. The signals also help the atria and ventricles work together in the same rhythm. The blood from the atria is pushed into the ventricles and leave the heart to circulate to the rest of the body.

Atrial flutter is a type of abnormal fast beating ( arrhythmia) in the atria. These fast beats make it difficult for the atria to pushing all the blood into the ventricles. As a result, the ventricles push less blood through the body.

Atrial flutter may be an acute or chronic disorder that comes and goes. Atrial flutter is not usually life-threatening when it is treated. However, it may increase your risk of developing blood clots and stroke.

This condition can be treated. Contact your doctor if you think you may have atrial flutter.

Causes

Atrial flutter may be caused by the following:

• Coronary artery disease
• Heart surgery–atrial flutter is most common during the first few weeks after open-heart surgery
• Disease in other parts of the body that affects the functioning of the heart, such as the lungs
• Using substances such as caffeine, alcohol, diet pills, or certain types of prescription or over-the-counter medication that affect the electrical impulses of the heart
• Stress and anxiety

Risk Factors

Factors that increase your chance of atrial flutter include:

• Heart disease
• Heart surgery
• History of high blood pressure
• Abnormalities of the heart or heart valves (hypertrophy, mitral valve prolapse)
• Overactive thyroid gland ( hyperthyroidism)
• History of chronic lung disease ( emphysema, chronic obstructive pulmonary disease [COPD])
• High levels of stress or anxiety
• Chronic use of caffeine, alcohol, diet pills, or certain types of prescription or over-the-counter medication (such as cold medicines)

Atrial flutter is more likely to develop in older adults.

Symptoms

Atrial flutter does not always produce symptoms. However, symptoms, when present, may include:

• 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

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may also recommend that you see a cardiologist or arrhythmia specialist. This type of physician may be found in a larger hospital.

Your doctor may need pictures of your heart and information about how it functions. This can be done with:

• Echocardiogram
• Electrocardiogram (EKG)
• Holter monitor
• Electrophysiological study (EP)

Treatment

The goal of treating atrial flutter is to slow down the electrical impulses that are sent from the atria to the ventricles. Treatment aims at restoring normal rhythm and preventing future episodes. Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Prevention

To help reduce your chance of atrial flutter:

• Reduce or eliminate your use of caffeine, stimulants, alcohol, nicotine, certain medications, or recreational drugs
• Obtain treatment for any other heart or lung disease
• Reduce your levels of stress and anxiety
• Check with your doctor before taking any new medications, herbs, or supplements

Heart Rhythm Society http://www.hrsonline.org/

Heart and Stroke Foundation http://www.heartandstroke.com

Atrial flutter. Heart Rhythm Society website. Available at
http://www.hrsonline.org/Patient-Resources/Heart-Diseases-Disorders/Atrial-Flutter#axzz3MHkY4esv
Accessed November 9, 2012.

Lee KW, Yang Y, et al. Atrial flutter: a review of its history, mechanisms, clinical features, and current therapy. Curr Prob Cardiol. 2005;30(3):121-167.