What Is Atrial Flutter?

The heart comprises two upper chambers called left and right atria, two lower chambers, and left and right ventricles. The job of the two upper chambers is to receive (pump in) blood from the whole body, and the responsibility of the two lower chambers is to pump out the blood from the heart to distribute in your entire body.

The natural heart rate at rest is between 60 to 100 per minute, but it may fluctuate from minute to minute. A lower heart rate at rest implies the heart is functioning efficiently.

Understanding Atrial Flutter

The atrial flutter is when your upper chamber is beating too quickly. It is a heart rhythm disorder, an errant flutter in the atria. The heart’s electrical system causes the problem.

It happens when there is a short circuit in the electrical signals of the heart’s upper chamber, causing the heart to pump or beat fast.

Atrial flutter has an organized heart rhythm and is less chaotic, unlike atrial fibrillation, where the heartbeat pattern is irregular.

The Atrial Flutter Chain of Events Explained

The regular heartbeat begins in a small area in the heart’s right upper chamber called the atrium. It starts with an electrical impulse from the sinus node. If a short circuit of the heart’s electrical signal occurs, it causes atrial flutter. It follows a circular electrical pathway, causing the electrical impulse to gallop around the right atrium.

It leads to 240 to 340 heart contractions per minute. These rapid contractions prevent the heart chambers from filling well with blood between the beats. Along with the atrium, the lower heart chambers, called ventricles, start beating faster.

Here, the heart does not beat as rapidly as in the atrium. We can represent the heartbeat rate as the proportion of atrial beats to ventricle beats. For example, if the heart beats twice in the atrium and once in the ventricles, the ratio is 2:1 block.

Atrial Flutter Types

Classification of typical and non-typical (atypical) atrium flutters depends on the short circuit in the heart based on the pathway the electrical signals follow to move faster around the atrium part of the heart.

Typical Atrium Flutter

The flutter occurs locally in the right atrium. This flutter is curable with a short catheter ablation process.

Atypical (non-typical) Atrium Flutter

This flutter occurs in the left atrium. Catheter ablation can treat most flutters, including this one. For this flutter, the catheter ablation procedure is complex and involves a lot of other long processes.

Atrial Flutter Symptoms

People may have no atrial flutter symptoms. The increment in atrial flutter rate can cause stroke, heart failure and damage, and other heart complications. It may even cause permanent disability or death.

The atrial flutter symptoms can cause −

  • Chest pain and stroke

  • Strong palpitation (fluttering heartbeats in the chest)

  • Fainting, dizziness, or lightheadedness

  • Shortened breath

  • Fatigue or tiredness

  • Feet and leg swelling

Atrial Flutter Causes

Atrial flutter is an age-triggered arrhythmia. It rarely occurs before 50 years of age. Once it happens, it can become more regular. Visit a specialist for early medical attention.

The other common causes of atrial flutter are if you have gone through the following already.

  • Past heart or cardiac surgery

  • Catheter ablation for atrial fibrillation

  • Hypertension or high blood pressure

  • The higher the age, the higher the risk, which typically starts after 50

  • Diabetes, coronary heart disease, heart valve disease

  • Heart failure, congenital heart disease

  • Obesity and Alcohol

  • Sleep apnea

  • Over-exercising or high-intensity workout

  • Family medical history

Atrial Flutter Complications

An inefficient or suboptimal heartbeat can cause blood clot formation in the upper chambers because of the blood left to pool. If the clot moves out of the heart to the artery, it can create blockage and stroke.

If the heart causes atrial flutter to continue to pulsate for a long time, it can cause cardiomyopathy, which weakens the heart muscles.

Atrial Flutter Diagnosis

Doctors deploy an electrocardiogram or ECG/EKG to diagnose atria flutter. Doctors recommend other methods, such as a Holter monitor, an event monitor, or an electrophysiological study, in case the ECG does not effectively diagnose the heart condition.

In this method, a narrow and flexible tube called a catheter is threaded into your vein to the heart by applying light sedation. The catheter’s fine wires can help detect abnormal signals.

Atrial Flutter Treatment

Effective atrial flutter treatment involves medication or clinical procedures devised to scar small areas of heart tissue (ablation). Flutters may go away without treatment and action required. If it does not go away and persists, the doctors apply one of the following treatments.

Treating Underlying Conditions

Doctors diagnose for any other health conditions causing the atrial flutter.

Catheter Ablation

A non-surgical, catheter-based procedure can often heal atrial flutter. It involves threading wires through a vein through your leg to the heart.


Doctors give a short and controlled shock to the chest under anesthesia. It is an attempt to offer a short-term correction of the heart rhythm.

Medications to Bring the Abnormal Heart Rhythm under Control

We also know it as antiarrhythmics and may not be as effective as catheter ablation procedures.

Medications for Blood Clot Prevention

Blood clotting from atrial flutter could be life-threatening, as the clot may move into the artery, causing strokes. So doctors take measures by providing anti-blood clotting medication to prevent blood clots inside the heart.


Atrial flutter is a common heart rhythm abnormality (arrhythmia), caused by errant electrical signals in the upper chambers, also called the atrium. It makes the heart beat much faster than natural (between 60 to 100 per minute). The heart flutters do not get enough time to squeeze to trigger an optimal pump in and out.

This faster heart rate causes the heart not to function at its best, leading to various other health conditions, including blood clotting, stroke, and death. There is neither a cure nor any symptoms, but the flutter may go away naturally. But we recommend consulting a heart specialist if you experience a persistent health condition for a long time.

Updated on: 28-Apr-2023


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