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Atrial flutter is an abnormal rhythm of the heart’s upper chambers, which can cause palpitations and an abnormally fast heartbeat. It can be short-lived or chronic and is often associated with cardiovascular problems. Treatment options include medication, cardioversion, and ablation. In extreme cases, it can lead to heart failure and stroke.
An atrial flutter is an arrhythmia, or abnormal rhythm, of the atria of the heart. The atria are the two upper chambers of the human heart. Flutters occur most commonly in people with cardiovascular problems, but they can also affect healthy people. It is usually short-lived, disappears, or degenerates into atrial fibrillation, another form of arrhythmia that is usually chronic. There are two types of atrial flutter, type I and type II; the latter is rarer and causes a more rapid arrhythmia.
Atrial flutter is characterized by palpitations or an abnormal awareness of the heartbeat, along with tachycardia or an abnormally fast heartbeat. It’s not necessarily something to worry about and may, for example, simply be a sign of mild overexertion that resolves within minutes of strenuous activity decreasing. If the condition persists, however, especially in a person with any type of cardiovascular disease or weakness, it can also be accompanied by dizziness, shortness of breath, chest pains, and nausea.
In extreme cases, atrial flutter can lead to chronic dyspnea and even heart failure. It can also cause blood to pool in the atria and eventually form a blood clot in the heart. If the blood clot travels to the brain, a stroke can occur.
A rhythm that re-enters the right or left atrium causes atrial flutter. When the heart is functioning normally, a heartbeat will involve electrical impulses passing through each cell of the atrium only once. During flutter, some cells are slow to respond to the flutter. This causes the initial impulse to be misinterpreted, when slow cells eventually respond, resulting in a continuous cycle of electrical activity.
The resulting heartbeat won’t be as fast as the pulses in the atria, since heartbeat is measured by the contractions of the ventricles, the heart’s two lower chambers; however, it will be faster than normal. The atria transmit an electrical impulse to the ventricles through the atrioventricular node, which is able to slow down excessively fast impulses coming from the atria. When the atrioventricular node slows its impulse in this way, heart block occurs, resulting in the symptoms that characterize atrial flutter.
This condition can be treated with medicines to prevent blood clots and to control the rate or rhythm of the heart. Cardioversion, the application of low-current electrical energy to the heart, can also help return the heartbeat to normal. Ablation, in which a scar is surgically created to destroy the circuit in the heart that causes atrial flutter, is another option.
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