What is atrial flutter?
Atrial flutter is a common abnormal heart rhythm where the upper chambers (atria) of the heart are beating too fast. These fast atrial muscle contractions are out of sync with the lower chambers (ventricles) and can be dangerous if left untreated. Unlike atrial fibrillation which is an irregular heart rhythm, the atria in atrial flutter usually beat in a rapid regular manner.
The electrical system of the heart is responsible for making the heartbeat. Electrical impulses travel along a pathway in the heart and make the upper and lower chambers of the heart work together to pump blood. In atrial flutter, the electrical signal travels along a pathway within the right atrium. It moves in an organised circular motion, or “circuit,” causing the atria to beat faster than the ventricles. The ventricles receive their signals via the atrio-ventricular (AV) node. This node is responsible for delaying the signal to instruct the ventricular beat to allow a split second of time for the blood to travel between the upper and lower chambers of the heart. In atrial flutter, the AV node will receive more signals than usual from the atria and in most cases will allow (filter) a certain number through, often seen in a ratio of 1 in 2, 1 in 3 or 1 in 4 pattern. This maintains a degree of control and regularity in the ventricular rate.
What are the symptoms for atrial flutter?
Patients with atrial flutter usually continue to have a regular heartbeat, even though it is faster than normal. It is possible that patients may feel no symptoms at all. Others do experience symptoms, which may include: heart palpitations, shortness of breath and fatigue, a reduced exercise tolerance, pressure, tightness or discomfort in your chest and dizziness, lightheadedness, or fainting. If left untreated, the side effects of atrial flutter can, in selected individuals, lead to more serious conditions. There is a risk of stroke due to clot formation or heart failure due to the heart beating rapidly for long periods of time causing the heart muscle to become weak.
What assessment do I need if I have atrial flutter?
If the Cardiologist suspects atrial flutter, then a simple ECG can help confirm the diagnosis. Your doctor may recommend an Ambulatory ECG Monitor and Echocardiogram to further evaluate your condition. In selected patients, further investigations may be required.
What are the treatments for atrial flutter?
Although drugs that regulate heart rate and rhythm can be used in an attempt to control atrial flutter, this type of heart rhythm is particularly resistant to medications. Cardioversion is an alternative option where an electrical current is used to “shock” the heart back to its normal rhythm.
The most optimal recommended treatment is radiofrequency catheter ablation which is potentially curative treatment for atrial flutter and is associated with better success rates and much lower recurrence rates when compared to mediaction or cardioversion.