Atrial flutter and atrial fibrillation are heart conditions where the atria contract faster than normal, leading to ineffective blood pumping to the ventricles and an increased risk of heart failure or stroke. Treatment involves reducing heart rate and establishing a normal rhythm.
Atrial flutter and atrial fibrillation are both conditions that affect the upper chambers, or atria, of the heart. In both atrial fibrillation and flutter, the atria contract much faster than normal, with the result that blood is not pumped effectively to the lower chambers, or ventricles, of the heart. The rapid atrial contractions of atrial fibrillation are irregular and have a chaotic rhythm, whereas in atrial flutter, the contractions are regular. With atrial fibrillation, the ventricles beat irregularly, but, in the case of atrial flutter, they can beat regularly or irregularly. Both conditions carry an increased risk of heart failure or stroke.
The atria contract so quickly when this happens that the upper part of the heart trembles. Normally, the muscles lining the heart chamber walls contract in response to electrical impulse signals from the SA node, or pacemaker, within the right atrium. The impulses spread through the atria, causing them to contract, before passing through the so-called AV node and into the ventricles. In atrial fibrillation and flutter, random electrical impulses originate from the heart muscle and override the SA node, causing abnormal contractions.
When this happens, similar complications can occur. The ventricles beat faster than usual, although they don’t contract as quickly as the atria. They may not fill properly and the amount of blood ejected from the heart with each beat may decrease, with the risk of heart failure. The atria may not empty completely, and any blood left in the chambers may clot. If a clot escapes from the heart and lodges in an artery in the brain, a stroke could occur.
Atrial flutter is not as common as atrial fibrillation, but both conditions occur more frequently with increasing age. High blood pressure frequently causes both disorders. Symptoms of both atrial fibrillation and flutter can be similar and can include heart palpitations, shortness of breath, tiredness, and chest pain. The pulse in both conditions is typically faster than normal, but is likely to feel erratic in a person with atrial fibrillation and regular in someone with atrial flutter.
Treatment of this condition involves reducing the heart rate and establishing what is called a normal sinus rhythm. This includes treating any underlying conditions that may be causing the problem, such as a heart defect or hyperthyroidism. Medicines to lower the heart rate and correct the out-of-sync heart rhythm may be used, and medicines to prevent blood clots may also be given. A treatment called cardioversion delivers electric shocks to restore the heart’s normal rhythm. For people with atrial flutter, a method known as catheter radiofrequency ablation can be used to destroy areas of tissue in the heart that are responsible for the abnormal beats.
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