Atrial flutter – Symptoms, Causes and Treatment

Overview 

Atrial flutter is a type of irregular cardiac rhythm that can lead to various complications, including an increased risk of stroke. But there are remedies out there. You may be able to restore your normal heart rhythm with the aid of medications and treatments.

Atrial flutter and its types 

An abnormal heart rhythm, or arrhythmia, is called atrial flutter (AFL). It happens when the top chambers of your heart beat too quickly, making the lower chambers of your heart beat faster than usual.

Your heart’s ability to efficiently circulate blood throughout your body is hampered by Atrial flutter. If left untreated, Atrial flutter can harm your heart muscle and raise your chance of a stroke or blood clots.

Similar to the more prevalent disease, Atrial fibrillation (AFib), atrial flutter is characterised by irregular atrial racing, as opposed to Atrial fibrillation, which typically has a regular rhythm.

Atrial flutter types

Typical (most common type): In your right atrium, abnormal electrical impulses move in an anticlockwise direction.

Reverse typical: Your right atrium experiences abnormal clockwise electrical impulses.

Atypical: Your left or right atrium may experience unusual electrical impulses.

Based on the results of your electrocardiogram (EKG), your provider can determine which type of Atrial flutter you have.

Causes of Atrial flutter 

Researchers aren’t sure what causes Atrial flutter. It is believed to be the outcome of harm to the heart, its electrical system, or organs that have an impact on the heart.

A natural pacemaker regulates your heart rhythm called the sinus node. It’s in the right atrium. It electrically communicates with the left and right atria. These impulses instruct the heart on how and when to contract.

When you have an atrial flutter, a portion of the sinus node signal circulates continuously around the right atrium at an unusually high speed.

This causes the heart’s lower chambers to typically beat at about 150 beats per minute (bpm), while the upper chamber beats too quickly at between 250 and 320 bpm (the upper beats conduct in a 2:1 ratio to the bottom chamber).

In contrast, an average heart rate is between 60 to 100 bpm, where the chambers beat at the same speed. This is the pace at which blood is pushed out of the heart’s lower chamber and into the body.

Heart condition

Atrial flutter has a number of underlying heart conditions or abnormalities as a primary cause. 

Examples

• Heart surgery scars or cardiac ablation, a non-surgical procedure
• Treatment method for both Atrial flutter and Atrial fibrillation
• Reduced blood flow to the heart is typically caused by atherosclerosis which is the stiffening of the arteries or a blood clot.
• High blood pressure
• Muscle illness of the heart (cardiomyopathy)
• Heart valve disorders
• Enlarged heart chamber (hypertrophy or dilation)
• Heart incidents, such as a heart attack
• Blood clots in the lungs
• Non-cardiac surgery

Symptoms of Atrial flutter 

Atrial flutter can lessen the heart’s ability to move blood forward. It may cause the heart to pulse abnormally fast. Some individuals, however, show few or no signs. This is accurate if their heart is functioning normally and their heart rate is under control. If you do experience signs, they may consist of

· Shortness of breath

· Tiredness (fatigue)

· Chest pain

· Fainting

· Lightheadedness

· Swelling in your feet and legs 

· Fluttering heartbeats (palpitations)

Treatment of Atrial flutter 

The primary objective of your doctor is to get your heart rhythm back to normal. Your condition’s severity and how you react to medicine will determine your treatment.

The therapy of atrial flutter may also be affected by underlying health issues, which may require treatment.

Medications can regulate or slow your heart rate. Examples of these medications include

· Calcium channel blockers

· Beta-blockers

· Digoxin

Anti-arrhythmic medications, for example, may necessitate a short hospital stay while your body adjusts. Other drugs might be used to return the atrial flutter rhythm to a regular sinus rhythm. These kinds of drugs include amiodarone, propafenone, and flecainide.

Blood thinners can stop blood clots forming in vessels, such as non-vitamin K oral anticoagulants (DOACs). A heart attack or stroke may result from clotting. Atrial flutter patients are more likely to develop blood blockages. Based on their age, sex, and other risk factors, a scoring method called CHA2DS2-Vasc determines whether they need to take blood thinners.

Warfarin has traditionally been the anticoagulant of choice, but DOACs are now favoured because they don’t require routine blood testing for monitoring and have no known food interactions.

Surgery

Ablation therapy silences the heart tissue that is producing the abnormal rhythm. It is used when Atrial flutter cannot be controlled by medication or when medication side effects occur. Still, it is increasingly being given as a first-line atrial flutter treatment.

Alternative therapies

Cardioversion resets the heart beat out of atrial flutter by shocking it with electricity to return to normal. Paddles or patches applied to the chest cause shock after anaesthesia is given.

Diagnosis of Atrial flutter 

Doctors begin to think that if your resting heartbeat exceeds 120 beats per minute and atrial flutter is detected on your Electrocardiogram, you may have an Atrial flutter.

Your family background could be necessary for helping your doctor determine whether you have Atrial flutter. A history of anxiety, heart disease, and high blood pressure may influence your risk.

With the aid of an ECG, your primary care physician can make a preliminary determination of Atrial flutter. For additional testing, a cardiologist may also be recommended to you.

Diagnosis test includes

Echocardiograms

Ultrasound is used in echocardiograms to produce pictures of the heart. They can also gauge the blood flow through your heart and blood arteries and check for any indications that the heart is weakening due to tachycardia-induced cardiomyopathy or dilation of the atria (chambers of the heart where atrial flutter originates).

Electrocardiograms capture the electrical activity of your heart.

Holter monitors

You might be given this test if you have atrial flutter signs but a normal EKG. Because atrial flutter keeps coming back or perhaps you have premature heartbeats.

Your doctor can use this procedure to determine whether you have a serious arrhythmia and what kind it is. You will wear the monitor around your neck for a few days throughout your daily tasks. A doctor can use a holter device to track the heart’s rhythm for at least 24-72 hours.

Electrophysiology (EP) 

Heart rhythm can be recorded more invasively through electrophysiology (EP) tests. Your groin vessels are used to insert a catheter into your heart. Then, electrodes are inserted to track cardiac rhythm in different areas.

Prevention of Atrial flutter 

Although some risk factors for Atrial flutter are unavoidable, cutting back on drinking can help. Additionally, you can receive medical attention for the issues that lead to atrial flutter. These consist of

· Overactive thyroid

· Heart valve disorders

· Congenital disability in your heart

· High blood pressure

· Obstructive sleep apnea

· Obesity

· Coronary artery disease.

Risk factors of Atrial flutter 

The primary risk of atrial flutter makes it difficult for your heart to pump blood when it beats too quickly and effectively.

They may collapse if vital organs like the brain and heart muscles don’t receive enough blood.

There is a chance of congestive cardiac failure, heart attack, and stroke. Atrial flutter rarely poses a life-threatening danger when adequately managed. Atrial flutter complications can be fatal but are almost always avoided with therapy.

Living with atrial flutter

An irregular heart rhythm can impact how well you can work, exercise, and perform other tasks. Follow the treatment schedule that your doctor recommends to control it. Drugs and other treatments can help you manage symptoms like palpitations and loss of breath while also reducing your risk of stroke or heart failure.

Eating healthy food is essential as well. You can prepare a healthy diet with the aid of your physician or a dietitian. Losing a few pounds could help you manage symptoms if you’re overweight.

You can regulate your heart rhythm by exercising. Find out from your doctor what activities are risk-free for you and how to begin a new programme.

When to consult a doctor? 

Atrial flutter complications can be serious if left untreated. If you experience any potential signs or symptoms of atrial flutter, consult your doctor.

Summary

A fast heart rhythm in the upper portion of your heart is called atrial flutter. You might be at risk for a stroke or heart failure if you don’t get therapy for atrial flutter. It’s important that you show up for your appointments with your healthcare practitioner. They can assess your risk of stroke and recommend ways to restore your heart’s regular rhythm. Your healthcare practitioner can advise you on the best course of action. 

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