Ask the Experts

What is Atrial Flutter?

Author: Dr. Drory S. Tendler

Answer: Atrial flutter (AFL) is a common abnormal heart rhythm, similar to atrial fibrillation, the most common abnormal heart rhythm. In AFL, the upper chambers (atria) of the heart beat too fast, which results in atrial muscle contractions that are faster than and out of sync with the lower chambers (ventricles).

The normal heartbeat begins as a single electrical impulse that comes from the sinoatrial node in the upper right atrium. The impulse sends out an electrical pulse that causes the atria to contract (squeeze) and move blood into the lower ventricles. The electrical current passes through the atrioventricular (AV) node (the electrical bridge between the upper and lower chambers of the heart), causing the ventricles to squeeze and release in a steady, rhythmic sequence. With AFL, the electrical signal travels along a pathway within the right atrium in an organized circular motion, or “circuit”. AFL makes a very distinct “sawtooth” pattern on an electrocardiogram (ECG), the most common test used to diagnose this arrhythmia. Patients with AFL will often experience heart palpitations, shortness of breath, exertional difficulty, chest pain or pressure, dizziness, lightheadedness, or fainting.

AFL itself is not life threatening. AFL makes it harder for the heart to pump blood effectively, therefore with the blood moving more slowly, it is more likely to form clots. If the clot is pumped out of the heart, it could travel to the brain and lead to a stroke. Depending on the patient’s age and medical history, use of anticoagulation medications might be necessary.

Without treatment, AFL can also cause a fast pulse rate for long periods of time. When the ventricles beat too fast for long periods of time, the heart muscle can become weak. This condition is called cardiomyopathy. This can lead to heart failure and long-term disability. Treatment options include the initiation of anti-arrhythmic medications or a catheter based ablation procedure which can cure you of this condition. If you suffer from this arrhythmia, a consultation with a specialist is recommended, to learn more about your treatment options.

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