Atrial Flutter

What is an Atrial Flutter?

Similar to atrial fibrillation, atrial flutter is a condition where the heart beats irregularly. Occurring in the right atrium (upper right corner) of the heart, atrial flutter is characterized by a rapid heartbeat that can get as fast as 300 beats per minute.


Scaring from heart surgery may contribute to the development of the condition by disrupting the flow of electrical signals. Flutters may also be caused by artery blockages resulting from coronary artery disease. Contributing health issues can include persistent stress, heart valve irregularities, heart disease, and high blood pressure.


Diagnosis starts with a thorough medical exam and an EKG to measure heart activity. Treatment depends on the extent of any underlying issues contributing to AFL. Medications for atrial flutter may slow the heart rate enough to restore normal rhythm. Some medications require hospitalization so dosages can be adjusted and patients can be monitored.

What are the Symptoms of Atrial Flutter?

After atrial flutter develops symptoms can appear quickly and stop abruptly.

Symptoms include

  • Rapid heart rate
  • Shortness of breath
  • Dizziness, fainting, or a lightheaded feeling
  • Chest pressure or tightness

Atrial Flutter Causes

While the overall cause of atrial flutter is abnormal function and electrical signaling in the heart, there are many risk factors that can influence its development. Behavioral and lifestyle factors play significant roles in the development of atrial flutter. Excessive alcohol use, smoking, obesity, and high-fat diets have been shown to influence the onset of cardiac conditions such as coronary artery disease, diabetes, and hypertension, which can lead to heart arrhythmias. In conjunction with the structural abnormalities that can result from these influences, excessive alcohol use and smoking can also cause interruptions in the electrical signals of the heart, causing arrhythmias.

Additionally, chronic conditions such as hypercholesterolemia, sleep apnea, and congestive heart failure can lead the structural abnormalities such as plaque buildup and detrimentally influence electrical signaling in the heart. A high level of stress is also a significant risk factor. Because of the detrimental effects that stress has on the cardiovascular system, it can lead to the cardiovascular issues that influence the development of heart arrhythmias, such as atrial flutter. In addition to these causes, congenital heart dysfunction, and other conditions such as hyperthyroidism, pulmonary embolism, and chronic obstructive pulmonary disease (COPD) can lead to the development of atrial flutter as well.

How is Atrial Flutter Treated?

Atrial flutters can be intermittent, although the condition can remain present for several days or weeks at a time. Risk factors for AFL include a family history of heart conditions, excess weight, anxiety, and high blood pressure. The condition can often be managed with a combination of medication and lifestyle adjustments such as learning to better control stress.

Treatment includes

  • Blood thinners to prevent clots in arteries
  • Ablation therapy to remove tissue that may be causing the irregularity
  • IV calcium channel blockers or beta blockers
  • Catheter-based ablation (with radio-frequency energy)
  • Cardioversion, or defibrillation, using electricity to restore the heart’s normal pace (often recommended for patients whose AFL is considered unstable or uncontrollable with medication alone)

Atrial Flutter Prevention

Given the confluence of factors that lead to the development of atrial flutter, there are many steps that can be taken to help prevent its development. Maintaining a healthy diet, with an emphasis on fresh fruits and vegetables and healthy fats, can help prevent the leading causes of atrial flutter including hypertension, diabetes, and coronary artery disease. Additionally, regular exercise has been shown to cause positive cardiovascular adaptations. In relation to this, smoking cessation and reducing alcohol intake can also significantly decrease the risk of atrial flutter.

Another effective prevention tool is regular check-ups with your physician. Not only can this help monitor signs and symptoms of conditions that can lead to atrial flutter, they can also provide medications to help treat the effects of conditions such as hypertension, hypercholesterolemia, and diabetes. In addition, continued monitoring and treatment of congenital cardiac conditions and other issues such as hyperthyroidism can help prevent sequelae such as atrial flutter. Importantly, management of stress also helps prevent the development of cardiovascular conditions that can cause heart arrhythmias such as atrial fibrillation.