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Atrial Flutter

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Atrial flutter is the most common abnormal heart rhythm seen in healthy individuals as well as people with cardiovascular disease. It causes rapid and at times irregular heart beat. These abnormalities in the heart beat or rhythm are called as arrhythmias.

What is Atrial Flutter?

The abnormal heart rate in the upper chambers of the heart, that is, the atria, is called as atrial flutter. The atria beats faster than the ventricles (lower chamber), causing heart rhythm complications.

The rate of the atrium is 200 to 300 beats/minute under normal conditions.  The electrical signals from the atria to the ventricle travels through a connector called the A-V node. The rate at which the ventricles beat is considered the rate of heart beat, which is 75 to 150 beats/ minute. Any problem with the electrical system of the heart, can lead to atrial flutter.

Atrial flutter is similar to atrial fibrillation.  Flutter is a more organized condition and fibrillation is more chaotic. One can describe flutter as a rapid vibration or pulsation.However, in some people, one can observe both atrial flutter and atrial fibrillation.

Symptoms of Atrial Flutter

People with atrial flutter continue to have a steady heartbeat that is faster than normal. This is because the electrical signals during a flutter travel in an organized and predictable pattern. So, most people with atrial flutter, never experience any symptoms. However, those who do, have the following symptoms:

  • Heart palpitations
  • Shortness of breath
  • Fast and steady pulse
  • Pain, tightness or discomfort in the chest
  • Lightheadedness
  • Fainting spells
  • Fast and steady pulse
  • Nausea
  • Feeling of impending doom
  • Swelling of the legs or abdomen
  • Nocturnal breathlessness

Classification of Atrical Flutter

Atrial flutter is classified into two types, type I, the most common typeand  type II, which is rarely observed.

Type I

The common atrial flutter or the typical atrial flutter is the condition where the atrial rate is about 20 to 340 beats/min.

Type II

The type II flutter has a faster atrial rate of about 340 to 440 beats/min.

Causes of Atrial Flutter

Atrial flutter usually occurs in people with hypertension, coronary artery disease and cardiomyopathy. It occurs spontaneously in people with otherwise healthy heart. Other factors that can cause atrial flutter include:

  • Heart valve abnormalities
  • High blood pressure
  • Thyroid dysfunction
  • Chronic lung disease
  • Diabetes
  • Alcoholism

Diagnosis of Atrial Flutter

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Atrial flutter is discovered with the help of an electrocardiogram. Presence of flutter waves at a regular rate of 240 to 440 beats/min with symmetrical flutter waves that appear like p-waves or asymmetrical with a sawtooth appearance. If the flutter is not recognized on an ECG clearly, the doctor may suggest the use of Lewis lead ECG.

Management of Atrial Flutter

Atrial flutter can lead to thrombus in the atria just like atrial fibrillation. Thus, the doctor may prescribe anticoagulation or anti-platelet agents. For treating the flutter, the doctor may suggest cardioversion as it helps in reverting the sinus rhythm. Another common treatment or atrial flutter includes ablation of the isthmus. The circuit that causes atrial flutter is ablated and thus, treating the typical flutter.

Complications Related to Atrial Flutter

Atrial flutter is not a life threatening condition. However, when left untreated, it can lead to potentially fatal complications. It could lead to:

  • Thrombosis
  • Stroke
  • Heart attack
  • Cardiomyopathy
  • Heart failure
  • Sudden cardiac death

Medications help in treating atrial flutter. One should stop smoking, reduce stress in life and live a healthy lifestyle to avoid and get rid of atrial flutter.

Written by: Saptakee sengupta
Date last updated: April 06, 2015