Paroxysmal Atrial Flutter

Paroxysmal Atrial Flutter

What is atrial flutter? — Atrial flutter is a heart problem in which the heart beats much faster than normal. Atrial flutter puts people at risk for stroke and other problems.
In atrial flutter, the electrical signals that control the heartbeat become abnormal. As a result, the heart's upper chambers stop pumping effectively. Blood that should move out of these chambers gets left behind. As the blood pools, it can start to form clots. These clots can travel up to the brain through the blood vessels, and cause strokes.
Atrial flutter happens most often in people who had recent heart surgery or who have certain heart conditions, such as a heart valve problem.
What are the symptoms of atrial flutter? — Some people have no symptoms. When symptoms do happen, they can include:
Feeling like your heart is beating fast, beating hard, or skipping beats
Feeling tired
Feeling light-headed or dizzy
Trouble breathing
Chest pain
Fainting, or feeling like you are going to faint
Is there a test for atrial flutter? — Yes. Your doctor or nurse will do an electrocardiogram (also called an "ECG"), which measures the electrical activity in your heart (figure 1).
Your doctor will also do other tests to look for heart problems that could be causing your atrial flutter. These can include:
A chest X-ray
An echocardiogram (also called an "echo") – This test uses sound waves to create a picture of the heart as it beats (figure 2).
An exercise stress test – During this test, the doctor will record your ECG while you exercise on a treadmill or bike (figure 3).
A home heart monitor – This test records your heartbeat over the course of hours or days.
How is atrial flutter treated? — Treatment depends on your symptoms and what's causing your atrial flutter.
People who have no symptoms might not need treatment. This is because atrial flutter sometimes changes back to a normal heart rhythm without treatment (after days or weeks).
When treatment is needed, it can include 1 or more of the following:
Medicines to change the heart rhythm back to normal, or control the speed or rhythm of the heartbeat
Medicines to prevent blood clots from forming
Cardioversion – During this procedure, the doctor gives the heart a mild electrical current to change the rhythm back to normal.
Ablation – During this procedure, the doctor uses heat or cold to destroy the small part of the heart that is sending the abnormal electrical signals.
A pacemaker – This is a device that goes under the skin near a person's heart. It sends electrical signals to the heart to control the heartbeat.
What will my life be like? — Many people with atrial flutter are able to live fairly normal lives. Still, it is important that you take your medicines every day, as prescribed by your doctor. Taking your medicines will help lower the chances that your atrial flutter will cause a stroke. Even so, it's a good idea to learn the signs and symptoms of a stroke (figure 4).
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 83438 Version 6.0
Release: 28.2.2 - C28.105
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