The atria are the top chambers of the heart. The ventricles are the bottom chambers. In atrial flutter, the atria start to beat rapidly because of too many abnormal electrical impulses. The atria flutter as they try to contract, but the contractions are too fast. Atria may beat up to 300 times per minute, instead of 60 to 100. About one-half to one-fourth of these impulses get to the ventricles. Atrial flutter more often occurs in older adults, mostly men.
Different illnesses can cause atrial flutter. Heart and lung disease, thyroid disease, and heart valve disorders are most often associated with atrial flutter.
Main symptoms are palpitations (feeling that the heart is pounding or racing), dizziness, lightheadedness, and feeling faint. Angina or heart failure can occur. Angina is heart pain caused by a low blood supply to the heart. Breathing problems, chest pain, and fainting occur with heart failure.
The health care provider makes a diagnosis from the medical history, physical examination, and electrocardiography (ECG). ECG looks at the heart’s electrical conduction system and can confirm the diagnosis. Echocardiography may also be done. This test can see the motion of the atria and whether blood clots are in the atria. The health care provider may want laboratory tests to rule out other disorders such as overactive thyroid gland.
Treatment aims to fix the cause of the rhythm disturbance, slow the heart rate, and prevent blood clots. Keeping a normal regular heart rhythm is another goal.
Treatment depends on the symptoms and cause. Medicines help control the rate of contraction of ventricles and try to get back the heart’s normal rhythm (chemical cardioversion). If that doesn’t work or symptoms get worse, the heart is electrically shocked. This procedure is called electrical cardioversion. The brief electric shock stops the heart’s electrical activity and may allow normal heart rhythm to take over.
If all these measures don’t work, the health care provider may suggest an electrophysiologic study (EPS). A cardiologist specializing in heart rhythm problems does this test. EPS may help the health care provider decide about other treatment options such as radiofrequency ablation, pacemaker insertion, and surgery.
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