Atrial Flutter Overview, Causes and Symptoms

Atrial Flutter Overview

Atrial flutter is an abnormality of the heart rhythm, resulting in a rapid and sometimes irregular heartbeat. Such abnormalities, whether in the rate or regularity of the heartbeat, are known as arrhythmias.

The beating of the heart is controlled by electrical impulses.

• Under normal circumstances, these impulses are generated by the heart’s natural pacemaker, the sinoatrial (SA) or sinus node, which is located in the right atrium.
• The impulse travels across the atria, generating a contraction of the atria.
• The impulse pauses very briefly at the atrioventricular (AV) node, which is located in the upper part of the muscular wall between the two ventricles. This delay gives the blood time to move from the atria to the ventricles.
• The impulse then moves down and through the ventricles, generating the ventricular contraction, which pumps the blood out of the ventricles.

Atrial flutter occurs when these electrical impulses take an abnormal path through the atria, typically circulating around the tricuspid valve in the right atrium.

• The abnormal path of the impulses makes the atria contract very rapidly, typically about 250-350 beats per minute. The normal heart rate is 50-100 beats per minute.
• These rapid contractions are slowed when they reach the AV node often with every second or third contraction reaching the ventricle.
• The heart beats in a regular rhythm, but it beats rapidly.
• This type of rhythm is called tachycardia (rapid heartbeat). Because atrial flutter comes from the atria, it is sometimes called a supraventricular (above the ventricles) tachycardia.

The main danger of atrial flutter is that the heart does not pump blood well when it is beating too fast. When blood is not pumped well, vital organs, such as the heart and brain, may not get enough oxygen from the blood.

Atrial flutter can come and go; it is then known as paroxysmal atrial flutter. More often, atrial flutter lasts for days to weeks and is known as persistent atrial flutter.

With proper treatment, atrial flutter is rarely life- threatening. Complications of atrial flutter, in particular stroke, can be devastating, but they can be prevented with medications (”blood thinners”) such as warfarin (Coumadin).

Atrial Flutter Causes

Atrial flutter may be caused by abnormalities of the heart, by diseases of the heart, or by diseases elsewhere in the body that affect the heart. Atrial flutter may also be caused by consuming substances that change the way electrical impulses are transmitted through the heart. Atrial flutter can occur after open heart surgery. In a few people, no underlying cause is ever found.

Heart diseases or abnormalities that can cause atrial flutter include the following:

• Decreased blood flow to the heart (ischemia) due to coronary heart disease, hardening of the arteries (atherosclerosis), and/or a heart attack
• High blood pressure (hypertension)
• Disease of the heart muscle (cardiomyopathy), especially associated with congestive heart failure
• Abnormalities of the heart valves, especially the mitral valve
• An abnormally enlarged chamber of the heart (hypertrophy)

Diseases elsewhere in the body that affect the heart include the following:

• Overactive thyroid gland (hyperthyroidism)
• A blood clot in a blood vessel in the lungs (pulmonary embolism)
• Chronic (ongoing, long-term) lung diseases, such as chronic obstructive pulmonary disease (COPD) and emphysema, that lower the amount of oxygen in the blood

Substances that may contribute to atrial flutter include the following:

• Alcohol (wine, beer, or hard liquor)
• Stimulants such as cocaine, amphetamines, diet pills, cold medicines, and even caffeine

Atrial Flutter Symptoms

Some people have no symptoms with atrial flutter. Others describe the following symptoms:

• Palpitations (a rapid heartbeat or a pounding sensation in the chest)
• A fluttering feeling in the chest
• Shortness of breath
• Anxiety
• Weakness

People with underlying heart or lung disease who experience atrial flutter may have these symptoms as well as the following more significant symptoms:

• Angina pectoris (chest or heart pains)
• Feeling faint or light headed
• Fainting (syncope)

other article:

• Atrial Flutter Treatment

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