Atrial Flutter

Diagnosis

Atrial flutter is typically diagnosed through a physical examination and heart rhythm testing. A healthcare professional listens to your heart, checks blood pressure, and asks questions about symptoms, medical history, and lifestyle habits. These steps help determine if the irregular heartbeat is due to atrial flutter or another condition.

Tests to Diagnose Atrial Flutter

Laboratory tests
Blood and urine tests help check for conditions that may affect heart rhythm. These may include evaluating thyroid, liver, and kidney function.

Electrocardiogram (ECG or EKG)
A quick and painless test that measures the heart’s electrical activity. Sticky patches with sensors are placed on the chest and sometimes limbs. Results show whether the heart is beating too fast or too slow.

Holter monitor
This portable ECG device is worn for 24 hours or longer to continuously record heart activity during regular daily activities.

Event recorder
This is another portable device, usually worn for up to 30 days. It records heart activity only during irregular episodes. You can activate it when you feel symptoms.

Implantable loop recorder
For those with infrequent symptoms, this small device is placed under the skin in the chest area. It continuously records heart rhythms over a longer period to detect irregularities.

Echocardiogram
This test uses sound waves to create real-time images of the heart. It shows heart structure, valve function, and blood flow.

Exercise stress test
Heart activity is monitored while walking on a treadmill or pedaling a stationary bike. If exercise isn’t possible, medications may be used to mimic its effects. Sometimes, an echocardiogram is combined with this test.

CT scan of the lungs
This test may be done to rule out a blood clot in the lungs, which can be associated with atrial flutter.

Electrophysiological (EP) study
Flexible tubes (catheters) are guided through a blood vessel, usually from the groin, to the heart. Sensors on the catheter tips record electrical signals and help locate abnormal areas causing atrial flutter.

Treatment

Treatment for atrial flutter depends on the severity of symptoms, overall health, and underlying causes. The goals are to restore normal heart rhythm, control heart rate, and reduce the risk of complications.

Medications

If atrial flutter is diagnosed, medications may be used to:

• Control the heart rate.

• Restore the normal rhythm.

• Prevent blood clots, especially if atrial fibrillation is also present.

These may include beta blockers, calcium channel blockers, or anti-arrhythmic drugs, depending on individual needs.

Cardioversion Therapy

If medication isn’t enough, cardioversion may be performed to reset the heart rhythm.

Electrical cardioversion
Patches or paddles on the chest deliver a controlled electric shock to restore normal rhythm. This is often used for unstable atrial flutter.

Pharmacologic cardioversion
Certain medications are given orally or intravenously to help reset the heart rhythm.

Cardioversion may be scheduled in a hospital or done urgently if symptoms are severe. Long-term medications are sometimes required afterward to maintain normal rhythm.

Radiofrequency Ablation

Radiofrequency ablation is a minimally invasive treatment for recurrent atrial flutter. It involves guiding catheters through blood vessels to the heart and using heat energy to create tiny scars. These scars block abnormal electrical signals that cause irregular heartbeats.

This procedure can:

• Significantly reduce flutter episodes.

• Improve heart rhythm stability.

• Enhance quality of life in people with frequent or severe symptoms.

Long-Term Management

• Regular follow-up visits are important to monitor heart rhythm and prevent complications.

• Lifestyle modifications such as maintaining a healthy weight, controlling blood pressure, reducing alcohol or caffeine intake, and managing sleep disorders can help lower the risk of recurrence.

• In some cases, long-term use of anticoagulants may be recommended to prevent stroke.