Atrial flutter is a type of abnormal heart rhythm that causes a rapid but regular heartbeat. It can lead to severe complications without treatment from a doctor.

Atrial flutter occurs when the upper chambers of the heart, or atria, beat much faster than the ventricles, which are the lower chambers.

According to one support group, over 200,000 people in the United States report atrial flutter each year.

This article will discuss what causes it, its risks, and how to treat it.

Abnormal heartbeat

A person with atrial flutter may experience a rapid but regular heartbeat.
The heart consists of two upper chambers (atria) and two lower chambers (ventricles). When the heart is working normally, an electrical signal causes the atria (the storage chamber) to squeeze blood into the two lower ventricles (the pumping chamber) before filling up again.

This creates a coordinated rhythm that allows the heart to pump blood around the body continuously.

In atrial flutter, a problem with the electrical system causes the upper atria to beat much faster than the ventricles.

Flutter vs. fibrillation
The condition is similar to atrial fibrillation in that both affect the atria and cause a rapid heartbeat. However, atrial flutter results in a fast and regular heartbeat, whereas atrial fibrillation usually results in a quick and irregular heartbeat.

Both conditions can increase the risk of blood clots forming in the top chambers of the heart, which can increase the risk of stroke.

Causes
The sinus node is a small cluster of cells on the right atrium that generates electrical signals to control all chambers of the heart.

In atrial flutter, the sinus node sends electrical signals in a circular motion, or a circuit, around the atria, causing them to beat very quickly. The ventricles do not receive so many of these electrical signals and are unable to beat as quickly.

A range of conditions can lead to an abnormal heartbeat, including lung disease, high blood pressure, diabetes, scar tissue or history of ablation, sleep apnea, or valve dysfunction.

Any conditions that put stress on the heart or increase the pressure and stretch of the atria can lead to an irregular heartbeat.

Sometimes, however, doctors and other health experts are unclear exactly what causes atrial flutter.

Symptoms
Typically, people with atrial flutter have a regular, rapid heartbeat, although this is not always the case.

Other people might experience symptoms that include:

• shortness of breath
• difficulty exercising or performing daily activities
• chest pain
• a racing or pounding heartbeat
• dizziness and lightheadedness
• fainting
• fatigue or weakness
• swelling in the legs
• According to the Heart Rhythm Society, some people do not experience any symptoms.

Risk factors
In some cases, there is no apparent cause of atrial flutter, but some risk factors include:

• high blood pressure
• diabetes
• obesity
• obstructive sleep apnea
• heart disease
• an overactive thyroid
• chronic airways disease (COPD) or another lung disease
• pneumonia
• high alcohol consumption
• heart surgery
• valve disease
• a blood clot in the lung
• electrolyte abnormalities
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Diagnosis
Doctors diagnose atrial flutter by recording and assessing the heart’s rhythm. Methods to do this include:

Electrocardiography (ECG): This is a quick and painless procedure where doctors amplify electrical signals from the heart and record them.
Holter monitoring: Doctors use a portable ECG device to record heart rhythm over 24–72 hours.
Event monitoring: This involves a doctor taking ECG readings over several days or weeks.
Implantable loop records: This involves placing an invasive monitor under the skin on the left side of the chest near the heart. It records ECG or electrical activity over several months or years.
The type of diagnosis procedure a doctor uses will depend on the nature of the condition. Sometimes, atrial flutter occurs in short bursts that make it hard for doctors to detect. In these cases, a doctor might use event monitoring.

Treatment
Treatments for atrial flutter aim to reduce symptoms and the risk of complications. The specific treatment will vary from person to person.

According to the American Heart Association (AHA), people can take a variety of medications to treat an irregular heartbeat.

Beta-blockers can slow the heart rate, and antiarrhythmic medications can help control heart rhythms by suppressing the abnormal electrical signals. Regularly taking these drugs can prevent episodes of atrial flutter.

Doctors may also prescribe blood-thinning medications to reduce the risk of complications. These drugs prevent blood clots from forming and can lower the chances of a stroke.

In some cases, doctors might prescribe electrical cardioversion. This involves placing electrodes on the chest and back to restore proper electrical signaling through a shock to the heart.

Another option is cardiac ablation. Doctors will thread tiny tubes through a vein in the leg to reach the heart. The procedure uses heat energy to destroy electrical areas where the flutter is originating in the heart.

Complications
Atrial flutter can lead to severe complications if left untreated.

Atrial flutter can cause blood to move more slowly around the body or pool in the atria. This increases the chances of a blood clot, which can lead to a stroke or heart attack.

Other complications might occur from having a rapid heartbeat over long periods. Maintaining this rapid heartbeat can weaken the heart muscles, causing cardiomyopathy.

Cardiomyopathy makes it harder for the heart to pump blood around the body. This may eventually lead to heart failure.

When to see a doctor
It is essential to see a doctor for any signs of abnormal heart rhythm. The condition is not usually life-threatening at first, but it can lead to complications without treatment.

A person may not always notice an abnormal heart rhythm at first. It may become more apparent as symptoms develop. Anyone who experiences symptoms, such as shortness of breath, heart palpitations, fatigue, or difficulty performing daily activities, should see a doctor for a diagnosis.

Outlook
People with atrial flutter may require long-term treatments. This might involve regular medication, surgery, or a combination of treatments.

Treatments can control the symptoms of atrial flutter and reduce the risk of complications. In some cases, the condition can return and require further treatment.

Summary
Atrial flutter is an abnormal heart rhythm that causes a rapid heartbeat. It can cause symptoms that include dizziness, fatigue, shortness of breath, and heart palpitations.

Anyone with atrial flutter should see a doctor immediately. Treatments are necessary to control symptoms and reduce the risk of complications.

The complications of atrial flutter can be severe, such as a stroke or heart failure.