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Atrial flutter is one of the atrial arrhythmias. It is characterized by a rapid activity of the atria of the heart, which indirectly increases the heart rate. Find out what atrial flutter is, what symptoms it has and what complications are associated with the occurrence of this arrhythmia.

How does the heart work?

Before explaining what fluttering is like, let's take a look at how the heart works.

Each heartbeat cycle consists of a contraction of the atria which causes the heart chambers to fill with blood, then the ventricles contract and blood is ejected to the aorta and pulmonary artery, after which the heart muscle relaxes, its cavities fill with blood and the cycle repeats itself. Under normal conditions, the work of the atria and ventricles is coordinated so that it is as efficient as possible. Sometimes, due to arrhythmia, this synchronization is disturbed, which negatively affects the efficiency of the heart.

The concept of arrhythmia is very broad. There are many types of it, they affect the atria, ventricles or both, they appear constantly or only periodically. Arrhythmias also affect the work of the heart to a very different extent - from completely harmless and asymptomatic to those causing cardiac arrest and posing a threat to life.

Atrial Flutter: Causes

Atrial flutter is more common in men than in women, and very rarely in he althy people. Most often it is caused by other heart diseases, such as :

  • valvular heart disease,
  • ischemic heart disease,
  • hypertension,
  • inflammation of the heart muscle.

Atrial flutter may also appear after cardiac surgery, in the course of hyperthyroidism or in lung diseases.

It also happens that atrial flutter is caused by a sudden disease process, e.g. a heart attack or pneumonia. Very rarely, this arrhythmia is a disease in itself with no apparent cause.

Atrial Flutter: Symptoms

Atrial flutter is usually recurrent. There are disease-free periods and arrhythmia attacks in its course. If the attack is caused by another disease, then once it has resolved,after recovery, the arrhythmia usually does not recur. However, if flutter is not organic (not caused by another condition), it may reoccur or become permanent. It also happens that this arrhythmia transforms into atrial fibrillation or there are periods of fibrillation and flutter.

In atrial flutter, the severity of symptoms usually depends on the underlying heart disease. The most common symptoms of atrial flutter are:

  • palpitations,
  • shortness of breath,
  • weakness,
  • chest pains.

Occasionally, people with atrial flutter may pass out - this usually happens during exercise. In this case, it is necessary to immediately diagnose the cause of these symptoms. However, it also happens that atrial flutter is completely asymptomatic.

Read also: Heart arrhythmia - what is the norm, and what is not?

Atrial Flutter: Diagnostics

Atrial flutter is found by performing an EKG test to see if an arrhythmia is present at the moment. In this case, the frequency of atrial beats (P waves) is very high, even up to 300 / min, such a record is called "saw teeth". The rate of QRS complexes indicating ventricular activity is less frequent, usually 150 bpm.

Another test performed in the case of suspicion of atrial flutter is a Holter EKG test, i.e. constant monitoring of the heart rate for 1 day, 3 or more - depending on the frequency of seizures. This test is ordered if an episode of atrial flutter is suspected but not found on a standard ECG.

The diagnosis of the causes of atrial flutter also includes :

  • laboratory tests - e.g. thyroid hormones,
  • echocardiographic examination (ECHO of the heart),
  • exercise test.

These tests are selected depending on the background of the arrhythmia suspected by the doctor.

Atrial Flutter: Treatment

The most important goal of atrial flutter therapy is to discover and treat the underlying cause. The method of treating the arrhythmia itself depends on the patient's condition.

If atrial flutter causes shock or haemodynamic instability, electrical cardioversion may be necessary, i.e. restoration of sinus rhythm with the help of current, or administration of anti-arrhythmic drugs that affect heart rate.

However, if the patient's condition is stable and the fluttering does not cause troublesome symptoms, treatment is initiatedpharmacological or performs elective cardioversion. This procedure is usually more effective than administering medications.

A possible treatment option is also atrial flutter ablation. Especially if the disease has no organic cause, and cardioversion has failed to return to the correct heart rhythm. This procedure is an invasive procedure consisting in destroying the foci of electrical activity responsible for the development of the disease. If the ablation is fully successful, usually atrial flutter does not recur.

It is worth knowing that in the case of this arrhythmia, as in the case of atrial fibrillation, it is necessary to use anticoagulant prophylaxis, ie administration of drugs that "thin the blood". It is recommended to prevent thromboembolic complications, including the most serious one - a stroke.

Read also: What is the most harmful to our heart?

Atrial Flutter: Summary

Atrial flutter is an arrhythmia very similar to atrial fibrillation in terms of symptoms, possible complications, and management. However, it differs in the frequency of the atria and the regularity of the ventricular rhythm.

In the event of fluttering, diagnostics are necessary to look for the cause of this arrhythmia, because it is often caused by an acute disease process, e.g. heart attack or pneumonia.

The basis of treatment is the elimination of any organic substrate, and if flutter occurs spontaneously - antiarrhythmic drugs, electrical cardioversion or ablation.

Atrial flutter: what is it?

Atrial flutter is one of several atrial arrhythmias. It is characterized by rapid electrical activity, and thus also atrial contractions, even up to 350 / minute. This arrhythmia is similar to the more common atrial fibrillation in that it causes the atria to work very quickly with little influence on the electrical activity of the ventricles.

The main difference, however, is that in the event of a flutter rhythm, the work of the ventricles is steady, regular, usually half as slow as atrial activity. This is because the atrioventricular node, through which stimulations from the atria to the ventricles are conducted, blocks some impulses, preventing them from being active so quickly. If this were not the case and all pulses were conducted, there would be ventricular tachycardia or even ventricular fibrillation - life-threatening rhythms.

Another difference between flutter and flutter is how often the atria work. In the case of the latter arrhythmia, the rhythm isfaster (over 350 / minute) and completely ineffective - the atria stop pumping blood, which negatively affects the efficiency of the whole heart.

About the authorBow. Maciej GrymuzaA graduate of the Faculty of Medicine at the Medical University of K. Marcinkowski in Poznań. He graduated from university with an over good result. Currently, he is a doctor in the field of cardiology and a doctoral student. He is particularly interested in invasive cardiology and implantable devices (stimulators).

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