Atrial Flutter

The heart beat (contraction) begins when an electrical impulse from the sinoatrial node (SA node) moves through it. The SA node is sometimes referred to as the heart's "natural pacemaker" because it initiates impulses for the heartbeat. These impulses follow a very specific pattern every time; however, this exact route must be followed for the heart to pump properly. As long as the electrical impulse is transmitted normally, the heart pumps and beats at a regular pace. In an adult, a normal heart beats 60 to 100 times a minute.

When the SA node has issues though, you get a change in your heart's rhythm. This is known as an arrhythmia. Almost everyone has felt some type of arrhythmia throughout their life. Some examples include: a “fluttery” feeling in the chest or the feeling of the heart “skipping” a beat. Don’t panic if you’ve occasionally had these symptoms, as most are harmless. However, arrhythmias that last for longer periods of time, may present some problems. One of these is atrial flutter (AFL)

During AFL, the electrical signals can sometimes go awry and produce an abnormal circuit inside the right atrium (heart’s upper chamber). This causes the atria to beat at a much faster pace (about 250-400 beats per minute) than the ventricles (heart’s lower chambers).

Atrial flutter is similar to atrial fibrillation (AFib). In atrial fibrillation, the heart beats fast and in no regular pattern or rhythm. With AFL, the heart beats abnormally fast, but in a regular pattern. Both of these conditions lead to a poor contraction of the atria which leads to blood pooling in the heart and can eventually lead to the formation of blood clots. If the blood clots become loose and travel in the bloodstream, this raises the significant risk for a stroke.

Causes of Atrial Flutter

Although the exact cause is unknown, certain conditions, traits or habits may raise your risk for the disease. These conditions are known as risk factors and include:

Non-modifiable risk factors: These factors are irreversible and cannot be changed. The more of these risk factors you have, the greater your chance of developing atrial flutter.

  • Older age
  • Family history/Genetics
  • History of previous heart attack

Modifiable risk factors: These factors can be modified, treated or controlled through medications or lifestyle changes.

  • High blood pressure
  • Diabetes
  • Obesity or having a body mass index “BMI” of 30 or greater
  • Excessive alcohol consumption over many years
  • Excessive amount of caffeine or other stimulants
  • Extreme emotional stress
  • Smoking or drug use

Other conditions that contribute to the development of AFL

  • Congenital heart disease
  • Heart surgery
  • Heart valve disease
  • Heart failure
  • Obstructive sleep apnea: a condition in which your breathing abruptly stops and starts while sleeping.
  • Thyroid disease: a condition that is caused by the over or under function of the thyroid gland. The thyroid gland is an essential organ for producing thyroid hormones, which maintains the body’s metabolism.

Symptoms of Atrial Flutter

The electrical signal that causes AFL circulates in an organized, predictable pattern. This means that people with AFL usually continue to have a steady heartbeat, even though it is faster than normal. It is possible that people with AFL may feel no symptoms at all. Others do experience symptoms, which may include:

  • Chest pain, fullness, discomfort or pressure
  • Confused or impaired thinking
  • F.A.S.T: face drooping, arm weakness, speech difficulty and time to call 911
  • General fatigue or fatigue when exercising
  • Rapid heart rate (tachycardia) of over 100 beats per minute
  • Heart palpitations: when you feel like your heart is racing, pounding or fluttering
  • Lightheadedness/Fainting
  • Shortness of breath

Diagnosis of Atrial Flutter

To diagnose atrial flutter, your doctor may review your signs and symptoms, medical history and conduct a physical examination. After that, you may have:

Diagnostic tests and procedures

Treatment of Atrial Flutter

The atrial flutter treatment that is most appropriate for you will depend on how long you've had atrial flutter, how bothersome your symptoms are and the underlying cause of your atrial flutter. Treatment options include:

Lifestyle changes

  • Avoid smoking
  • Eat a heart-healthy diet
  • Exercise under the directions of your doctor
  • If you're overweight, talk to your doctor about weight-loss options
  • Manage stress
  • Limit alcohol consumption and caffeine consumption
  • Make and keep appointments to see your doctor for routine check-ups and follow-up tests.

Medications

  • Anticoagulants “blood-thinners” will help treat, prevent, and reduce blood clotting.
  • Beta blockers will help reduce your blood pressure.
  • Calcium channel blockers will help relax blood vessels and increase the supply of blood and oxygen to the heart while also reducing the heart's workload.

Medical and surgical procedures



Saint Barnabas Medical Center
94 Old Short Hills Road
Livingston, NJ 07039
(973) 322-5000
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Monmouth Medical Center
300 Second Avenue
Long Branch, NJ 07740
(732) 222-5200
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Monmouth Medical Center Southern Campus
600 River Avenue
Lakewood, NJ 08701
(732) 363-1900
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Clara Maass Medical Center
1 Clara Maass Drive
Belleville, NJ 07109
(973) 450-2000
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Community Medical Center
99 Highway 37 West
Toms River, NJ 08755
(732) 557-8000
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Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000
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Jersey City Medical Center
355 Grand Street
Jersey City, NJ 07302
(201) 915-2000
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RWJ University Hospital Hamilton
1 Hamilton Health Place
Hamilton, NJ 08690
(609) 586-7900
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Robert Wood Johnson University Hospital
1 Robert Wood Johnson Place
New Brunswick, NJ 08901
(732) 828-3000
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RWJ University Hospital Rahway
865 Stone Street
Rahway, NJ 07065
(732) 381-4200
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RWJ University Hospital Somerset
110 Rehill Avenue
Somerville, NJ 08876
(908) 685-2200
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