Atrial flutter (heart flutter) is a type of arrhythmia and more specifically a type of supraventricular tachycardia that is caused by an abnormal electrical short circuit in the top chambers of the heart (atria). The short circuiting results in a continual loop of electrical activation at a rate much faster than that of the sinus node (the body’s natural pacemaker), producing a heart rate often as fast as 150 beats per minute.
Symptoms may include heart palpitations (sensations of a racing heart), lightheadedness, chest tightness, shortness of breath and fainting.
Atrial flutter is primarily diagnosed by an electrical tracing of your heart known as an electrocardiogram (also known as EKG).
But not all patients are the same, and your atrial flutter may be paroxysmal, meaning that it only happens intermittently. In such cases, you’ll be asked to wear a heart monitor (also known as mobile telemetry or event monitor) that records your electrocardiogram continuously. Abnormal heart rhythms (arrhythmias) can be tracked remotely and recorded through an electrocardiogram that is used by your physician to help make a diagnosis.
Heart flutter can’t always be detected separate from other types of supraventricular tachycardia such as atrial fibrillation by an electrocardiogram or a heart monitor alone. They may require an electrophysiology study for specific determination.
Electrophysiology study (also known as EP study or EPS), is a procedure where catheters to record the heart’s electrical activity are inserted in a patient’s veins in the upper leg and guided into the heart. Medications, pacing through the catheters and the recording of the heart’s electrical signals help doctors identify cardiac arrhythmias. Patients commonly receive sedation and anesthesia to make them comfortable and pain-free during an electrophysiology study. The newest 3-D mapping equipment used during an EP study is available at Scripps for proper diagnosis and frequent treatment of atrial flutter.
Treatment may include:
- Antiarrhythmic medications that suppress the abnormal heart rhythm.
- Anticoagulation medication to reduce the risk of blood clots.
Minimally invasive procedures
- Radiofrequency ablation where a catheter emitting heat energy is advanced into the heart to cauterize the abnormal electrical circuit or focus. The procedure is performed in conjunction with an electrophysiology study.
- AV node ablation and pacemaker where the AV node is cauterized, disconnecting the electrical connections between the heart’s top and lower chambers. A heart pacemaker is implanted to set the heart rate of the bottom chambers to correct the heart arrhythmia.
- Left atrial appendage closure is the removal of the left atrial appendage from the left atrium with the goal of reducing the risk of stroke, while potentially eliminating the need for anticoagulation (blood thinning) medication.