Atrial Flutter
What is Atrial Flutter?
Atrial flutter is a common abnormal heart rhythm where the upper chambers (atria) of the heart are beating too fast. This results in atrial muscle contractions that are too fast and out of sync with the lower chambers (ventricles) and can be dangerous if left untreated.
The electrical system of the heart is responsible for making the heartbeat. Electrical impulses travel along a pathway in the heart and make the upper and lower chambers of the heart work together to pump blood.
In atrial flutter, the electrical signal travels along a pathway within the right atrium. It moves in an organized circular motion, or "circuit," causing the atria to beat faster than the ventricles.
What are the symptoms of Atrial Flutter?
People with atrial flutter usually continue to have a regular heartbeat, even though it is faster than normal. It is possible that people may feel no symptoms at all.
Others do experience symptoms, which may include:
- heart palpitations (feeling like your heart is racing, pounding, or fluttering),
- shortness of breath and fatigue,
- difficulty in everyday exercises or activities or pain,
- pressure, tightness, or discomfort in your chest and dizziness,
- lightheadedness, or fainting.
What are the risks of atrial flutter?
Atrial flutter itself is not life threatening. If left untreated, the side effects of atrial flutter can be potentially dangerous.
In atrial flutter, it is harder for the heart to pump blood effectively. With stagnation of blood, clots can form which can travel to the brain and lead to a stroke.
Without treatment, atrial flutter can also cause the heart to beat rapidly for long periods of time which may result in the heart muscle becoming weak, leading to heart failure.
What are the treatments options for atrial flutter?
Medication to control the heart rate or rhythm may be the most suitable treatment for some patients. This may be in the form of regular, daily medication to prevent episodes or single doses to take when you have an attack to try and stop it.
Cardioversion
If the Cardiologist suspects atrial flutter, then a simple ECG can help confirm the diagnosis. Your doctor may recommend an ambulatory ECG monitor and echocardiogram to further evaluate your condition. In selected patients further investigations may be required.
Although drugs that regulate heart rate and rhythm can be used in an attempt to control atrial flutter, it is particularly resistant to medications.
Cardioversion is an alternative option where an electrical current is used to "shock" the heart back to its normal rhythm. There is a significant recurrence rate of atrial flutter following cardioversion however.
First line treatment nowadays is radiofrequency catheter ablation which is the only curative treatment for atrial flutter and has been shown in trials to be better than drugs or cardioversion.
Cather Ablation
Catheter ablation is performed by a highly skilled team who work alongside the Cardiologists here at the London Cardiac Group who specialize in treating heart rhythm disorders.
During a flutter ablation, thin wires called catheters are fed to the heart via a vein in the groin. There are electrodes at the tip of the wires which detect electrical signals from different parts of the heart. Radio waves are used to create heat which terminates the flutter and blocks the abnormal electrical signals.
The procedure can be performed under general anaesthesia, or local anaesthesia with sedation, is safe and quick and patients can usually return home the same day.
