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Atrial Flutter Symptoms and Treatment Guidelines

Can you die from atrial flutter? Can atrial flutter go away by itself? How long can you live with atrial flutter? Let’s find out about atrial flutter symptoms and treatment!

Atrial Flutter Definition

Atrial flutter meaning: What is atrial flutter? Atrial flutter is an irregular heartbeat (arrhythmia) that makes the heart’s upper chambers (atria) and lower chambers (ventricles) beat at different speeds.

atrial flutter symptoms and treatment guidelines - atrial flutter vs atrial fibrillation icd 10

Atrial Flutter Causes

What causes atrial flutter? What is the most common cause of atrial flutter? Atrial flutter is usually caused by something else wrong with the heart, like coronary artery disease or a problem with the way the heart beats.

Few people have atrial flutter than fibrillation. It can happen to people with structurally normal hearts. Still, it happens more often in people with COPD, valvular or structural heart disease, ASD, or congenital heart disease that has been fixed by surgery.

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Atrial Flutter Diagnosis

  • Rapid, regular tachycardia with a 2 to 1 block in the AV node and a heart rate of 150 beats per minute in the ventricles. ECG shows atrial activity has a “sawtooth” shape (rate 300 beats per minute).
  • The chance of having a stroke is the same as with atrial fibrillation.
  • Catheter ablation is very effective and is thought to be the best treatment for typical atrial flutter.

Atrial Flutter Symptoms

Signs and symptoms of atrial flutter – What are some symptoms of atrial flutter?

Patients usually complain of heart palpitations, fatigue, or mild dizziness when they visit the doctor. However, suppose the arrhythmia goes unnoticed for a long time. In that case, the patient may show signs and symptoms of heart failure, such as shortness of breath, inability to exercise, and swelling, due to tachycardia-induced cardiomyopathy.

In the inferior leads of an ECG, atrial activity usually looks like a “sawtooth” (II, III, and AVF). The reentrant circuit makes the atria beat 250–350 times per minute. Every second, third, or fourth impulse is sent to the ventricles through the AV node.

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Atrial Flutter Treatment and Management Guidelines

Treatment of atrial flutter – What is the best treatment for atrial flutter?

Agents used to control atrial fibrillation are also used to control the rate of the ventricles, but it is usually harder to do. Changing atrial flutter to sinus rhythm with class I antiarrhythmic agents is also hard to do, and taking these drugs has been linked to a slowing of the atrial flutter rate to the point where 1:1 AV conduction can happen at rates higher than 200 beats per minute, leading to a collapse of the heart’s ability to pump blood. Ibutilide, a class III antiarrhythmic drug given through an IV, has been much more effective at stopping atrial flutter.

About 50–70% of patients return to sinus rhythm within 60–90 minutes after 1-2 mg of this agent is given through an IV. Electrical cardioversion is also very effective for atrial flutter, with about 90% of patients converting after synchronized shocks of as little as 25-50 J.

Even though the way the atrial contractile function is set up in this arrhythmia may protect against thrombus formation, the risk of thromboembolism is the same as with atrial fibrillation because these two arrhythmias often occur together.

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Anticoagulation is not needed before cardioversion for atrial flutter that has been going on for less than 48 hours unless there is mitral valve disease. As with atrial fibrillation, anticoagulation should be kept up for at least 4 weeks after electrical or chemical cardioversion and on a long-term basis in patients with risk factors for thromboembolism.

Because the procedure is safe and has a high success rate, catheter ablation is the best long-term treatment for atrial flutter. The anatomy of the typical circuit is well known, and catheter ablation in the right atrium immediately and permanently stops atrial flutter in more than 90% of patients. Because atrial flutter and atrial fibrillation often happen together, some patients may need catheter ablation of both arrhythmias. Antiarrhythmics of class III (like amiodarone or dofetilide) is usually the best if drug therapy is chosen.

All people with atrial flutter should be sent to a cardiologist or cardiac electrophysiologist so that catheter ablation can be considered a permanent treatment.

I hope you understand atrial flutter symptoms and treatment guidelines.

About Micel Ortega

Dr. Micel Ortega, MD, PhD, is a highly respected medical practitioner with over 15 years of experience in the field of internal medicine. As a practicing physician, Dr. Micel has built a reputation for providing compassionate and evidence-based care to his patients. He specializes in the diagnosis and management of chronic conditions, including diabetes, hypertension, and heart disease. In addition to his clinical work, Dr. Micel has published extensively in top-tier medical journals on the latest advancements in internal medicine and has played an instrumental role in the development of innovative treatment options.

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