Atrial Flutter

What is Atrial Flutter

Atrial flutter is a type of abnormal heart rhythm (arrhythmia). The heart has an electrical system that tells the heart how to beat. In atrial flutter, the signals move rapidly in the top chambers of the heart (theatria).

This makes your heart beat very fast. Atrial flutter can come and go, or it can be permanent.

If this condition is not treated it can cause serious complications, such as stroke or weakened heart muscle (cardiomyopathy).

What are the causes?

This condition may be caused by:

  • A heart condition or problem, such as:
    • A heart attack.
    • Heart failure.
    • A heart valve problem.
    • Heart surgery.
  • A lung problem, such as:
    • A blood clot in the lungs (pulmonary embolism, or PE).
    • Chronic obstructive pulmonary disease.
  • Poorly controlled high blood pressure (hypertension).
  • Overactive thyroid (hyperthyroidism).
  • Caffeine.
  • Some decongestant cold medicines.
  • Low levels of minerals called electrolytes in the blood.
  • Cocaine.

What increases the risk?

You are more likely to develop this condition if:

  • You are an elderly adult.
  • You are a man.
  • You are obese.
  • You have obstructive sleep apnea.
  • You have a family history of atrial flutter.
  • You have diabetes.

What are the signs or symptoms?

Symptoms of this condition include:

  • A feeling that your heart is pounding or racing (palpitations).
  • Shortness of breath.
  • Chest pain.
  • Feeling light-headed.
  • Dizziness.
  • Fainting.
  • Low blood pressure (hypotension).
  • Fatigue.

Sometimes there are no symptoms associated with arrhythmia.

How is this diagnosed?

This condition may be diagnosed based on:

  • An electrocardiogram (ECG). This is a test that records the electrical signals in the heart.
  • Ambulatory cardiac monitoring. This is a small recording device that is connected by wires to flat, sticky disks (electrodes) that are attached to your chest.
  • An echocardiogram. This is a test that uses sound waves to create pictures of your heart.
  • A transesophageal echocardiogram (TEE). In this test, a device is placed down your esophagus. This device then uses sounds waves to create even closer pictures of your heart.
  • Stress test. This test records your heartbeat while you exercise and checks to see if the heart muscle is receiving adequate blood supply.

How is this treated?

This condition may be treated with:

  • Medicines to:
    • Make your heart beat more slowly.
    • Keep your heart in normal rhythm.
    • Prevent a stroke.
  • Cardioversion. This uses medicines or an electrical shock to make the heart beat normally.
  • Ablation. This destroys the heart tissue that is causing the problem.

In some cases, your health care provider will treat other underlying conditions.

Follow these instructions at home:


  • Take over-the-counter and prescription medicines only as told by your health care provider.
    • Make sure you take your medicines exactly as told by your health care provider.
    • Do notmiss any doses.
  • Do nottake any new medicines without talking to your health care provider.


  • Eat heart-healthy foods. Talk with a dietitian to make an eating plan that is right for you.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Limit alcohol intake to no more than 1 drink per day for nonpregnant women and 2 drinks per day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.
  • Try to reduce any stress. Stress can make your symptoms worse.
  • Get screened for sleep apnea. If you have the condition, work with your health care provider to find a treatment that works for you.
  • Do notuse drugs.
  • Avoid excessive caffeine.

General instructions

  • Lose weight if your health care provider tells you to do that.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your symptoms get worse.
  • You notice that your palpitations are increasing.

Get help right away if:

  • You have any symptoms of a stroke. “ BE FAST” is an easy way to remember the main warning signs of a stroke:
    • B – Balance.Signs are dizziness, sudden trouble walking, or loss of balance.
    • E – Eyes.Signs are trouble seeing or a sudden change in vision.
    • F – Face.Signs are sudden weakness or numbness of the face, or the face or eyelid drooping on one side.
    • A – Arms.Signs are weakness or numbness in an arm. This happens suddenly and usually on one side of the body.
    • S – Speech.Signs are sudden trouble speaking, slurred speech, or trouble understanding what people say.
    • T – Time.Time to call emergency services. Write down what time symptoms started.
  • You have other signs of a stroke, such as:
    • A sudden, severe headache with no known cause.
    • Nausea or vomiting.
    • Seizure.
  • You have additional symptoms, such as:
    • Fainting.
    • Shortness of breath.
    • Pain or pressure in your chest.
    • Suddenly feeling nauseous or suddenly vomiting.
    • Increased sweating with no known cause.


  • Atrial flutter is an abnormal heart rhythm that can give you symptoms of palpitations, shortness of breath, or fatigue.
  • Atrial flutter is often treated with medicines to keep your heart in a normal rhythm and to prevent a stroke.
  • You should seek immediate help if you cannot catch your breath, have chest pain or pressure, or have weakness, especially on one side of your body.

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