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Atrial Flutter

Atrial flutters are a type of heart arrhythmia where the heart's upper chambers (the atria) begin beating too rapidly. 

heart providers in operating room conducting electrophysiology studies

What is atrial flutter?

Atrial flutters are a type of heart arrhythmia where the heart's upper chambers (the atria) begin beating too rapidly. Atrial flutters originate from an error in the heart's electrical system. Electrical signals are emitted from the heart's sinus node (a small node of tissue in the right atria) and direct the heart's rhythm. With atrial flutter, this system effectively short circuits and sends the atria into a spiral of excessively rapid beats. Having this type of flutter in the heart can lead to some unpleasant symptoms but, more concerningly, can put you at risk of having a potentially debilitating or lethal stroke. 

What causes atrial flutter?

The specific causes of atrial flutter in any given case are often unknown. However, some variables contribute to the risk of developing these heart flutters. This condition is most common in people aged 50 or older. People may be more likely to develop atrial flutter if they have had past cardiac surgeries or have been treated with catheter ablation.

Atrial flutter symptoms

In some cases, atrial flutters do not cause any observable symptoms. When these heart flutters do present with symptoms, they can include the following: 

  • Rapid or irregular heart rate
  • Dizziness or fainting
  • Fatigue or exhaustion with minimal exertion 
  • Heart palpitations
  • Shortness of breath
  • Stroke

What are the risk factors of atrial flutters?

The association between atrial flutters, causes, and risk factors is still being researched. That said, several medical conditions may increase your risk of developing atrial flutter, such as:

How is atrial flutter diagnosed?

If your physician observes arrhythmia while listening to your heart or taking your pulse, they may order tests to check for atrial flutter. Electrocardiograms (ECGs) are the primary method of diagnosing atrial flutters. These devices use sensors (electrodes) that are temporarily attached to your chest with adhesive. These sensors pick up your heart's electrical signals and display them on a machine for your physician to analyze. 

Sometimes, an atrial flutter ECG may not be enough to complete the diagnosis. In those situations, your physician may recommend an electrophysiological study, an event monitor, or a Holter monitor. The first involves small wires inserted through your veins and into your heart to analyze the heart's electrical signals more accurately. The second two are akin to portable, wearable ECGs that can capture heart data over a longer time than a traditional ECG at the hospital. 

The condition can be diagnosed as either typical atrial flutter, located in the right atrium, or atypical atrial flutter, in the left atrium. Treatment can vary based on which type you are diagnosed with.

How is atrial flutter treated?

Atrial flutters aren't always chronic and may go away on their own. However, in cases where it persists, it can lead to stroke or heart failure. Therefore, it's vital to keep your physician apprised of your symptoms and consult with them about treatment. In cases where treatment is needed, your physician may utilize a few different approaches. In general, these treatments do not include any invasive surgeries. Common atrial flutter treatments are listed below.

  • Catheter ablation: This procedure uses small wires inserted into the heart through the veins. The wires are used to carefully neutralize tissue within the heart that may be causing the atrial flutter. This procedure may sometimes be referred to as an atrial flutter ablation. 
  • Cardioversion: While under anesthetic, this procedure applies a controlled electrical shock to the chest to reset the heart's rhythm. 
  • Atrial flutter medications: Drugs can be prescribed for blood thinning to prevent stroke, prevent blood clots, and slow your heart rate.
  • Treatment of underlying conditions: If atrial flutter is caused by or connected to another condition or illness, your physician may treat this underlying condition to see if doing so improves your atrial flutter. 

How to prevent atrial flutters

While atrial flutter causes are often unknown, you can take preventative measures. Following these guidelines may not provide complete atrial flutter prevention, but they may reduce your risks. 

  • Avoid heavy alcohol consumption
  • Avoid tobacco use
  • Maintain a healthy weight 
  • Treat any medical conditions you have that could increase your risk of developing atrial flutter
  • Treat or prevent high blood pressure

Living with atrial flutter

Ongoing treatment will often require medication to help prevent stroke risks from the atrial flutter and reduce the symptoms you experience. In some cases, atrial flutter may go away on its own. In others, the treatments may effectively cure the condition. However, for many who develop atrial flutter, regular care will be required to maintain good health. In those cases, your doctor will provide a care plan that may include recommended and prohibited exercises and activities, as well as a recommended heart-healthy diet.


The risk of stroke is one of the main dangers of atrial flutter. The seriousness can vary between cases, but even less extreme atrial flutters can become increasingly problematic over time. Because this condition weakens your heart's ability to pump blood, it can lead to blood clots within the heart that may later break loose and cause a stroke. 

Atrial flutter and atrial fibrillation (AFib) are both conditions that cause the heart to beat at a faster rate (tachycardia). The main difference is that AFib features a more chaotic rhythm while atrial flutters are more coordinated. While both can ultimately lead to strokes, atrial flutter may present a somewhat lower risk of stroke than atrial fibrillation. Atrial fibrillation also tends to present with more extreme symptoms than atrial flutter, although this is not always the case.

Some mild cases of atrial flutter may clear up on their own if the condition is not persistent. However, this condition has the risk of leading to a stroke. An atrial flutter can negatively impact the heart's ability to pump blood, which can lead to the buildup of blood within the heart. This buildup can harden into a blood clot. That blood clot may break loose into the bloodstream and make its way into the brain, getting stuck and causing a stroke.

Heart-healthy exercise is generally recommended with atrial flutter, but extra caution is often required. High-intensity exercise, or shifting into an intense workout too quickly, can put additional strain on your vascular system. Less caution may be required when the condition is managed, and the symptoms aren't extreme. Still, it's vital to consult with your physician about the specifics of your case to learn what exercise routines will be healthy and safe for you.

If left untreated, persistent atrial flutters may shorten your life expectancy by increasing your risk of stroke or heart failure. However, with proper atrial flutter treatment and management, people with this condition can often still live a long and relatively healthy life.