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Atrial flutter is a type of abnormal heart rhythm (arrhythmia). The heart has an electrical system that tells it how to beat. In atrial flutter, the signals move rapidly in the top chambers of the heart (the atria). This makes your heart beat very fast. Atrial flutter can come and go, or it can be permanent.

The goal of treatment is to prevent blood clots from forming, control your heart rate, or restore your heartbeat to a normal rhythm. If this condition is not treated, it can cause serious problems, such as a weakened heart muscle (cardiomyopathy) or a stroke.

What are the causes?

This condition is often caused by conditions that damage the heart’s electrical system. These include:

  • Heart conditions and heart surgery. These include heart attacks and open-heart surgery.

  • Lung problems, such as COPD or a blood clot in the lung (pulmonary embolism, or PE).

  • Poorly controlled high blood pressure (hypertension).

  • Overactive thyroid (hyperthyroidism).

  • Diabetes.

In some cases, the cause of this condition is not known.

What increases the risk?

You are more likely to develop this condition if:

  • You are an elderly adult.

  • You are a man.

  • You are overweight (obese).

  • You have obstructive sleep apnea.

  • You have a family history of atrial flutter.

  • You have diabetes.

  • You drink a lot of alcohol, especially binge drinking.

  • You use drugs, including cannabis.

  • You smoke.

What are the signs or symptoms?

Symptoms of this condition include:

  • A feeling that your heart is pounding or racing (palpitations).

  • Shortness of breath.

  • Chest pain.

  • Feeling dizzy or light-headed.

  • Fainting.

  • Low blood pressure (hypotension).

  • Fatigue.

  • Tiring easily during exercise or activity.

In some cases, there are no symptoms.

How is this diagnosed?

This condition may be diagnosed with:

  • An electrocardiogram (ECG) to check electrical signals of the heart.

  • An ambulatory cardiac monitor to record your heart’s activity for a few days.

  • An echocardiogram to create pictures of your heart.

  • A transesophageal echocardiogram (TEE) to create even better pictures of your heart.

  • A stress test to check your blood supply while you exercise.

  • Imaging tests, such as a CT scan or chest X-ray.

  • Blood tests.

How is this treated?

Treatment depends on underlying conditions and how you feel when you experience atrial flutter. This condition may be treated with:

  • Medicines to prevent blood clots or to treat heart rate or heart rhythm problems.

  • Electrical cardioversion to reset the heart’s rhythm.

  • Ablation to remove the heart tissue that sends abnormal signals.

  • Left atrial appendage closure to seal the area where blood clots can form.

In some cases, underlying conditions will be treated.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.

  • Do not take any new medicines without talking to your health care provider.

  • If you are taking blood thinners:

    • Talk with your health care provider before you take any medicines that contain aspirin or NSAIDs, such as ibuprofen. These medicines increase your risk for dangerous bleeding.

    • Take your medicine exactly as told, at the same time every day.

    • Avoid activities that could cause injury or bruising, and follow instructions about how to prevent falls.

    • Wear a medical alert bracelet or carry a card that lists what medicines you take.

Lifestyle

  • Eat heart-healthy foods. Talk with a dietitian to make an eating plan that is right for you.

  • Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.

  • Do not drink alcohol.

  • Do not use drugs, including cannabis.

  • Lose weight if you are overweight or obese.

  • Exercise regularly as instructed by your health care provider.

General instructions

  • Do not use diet pills unless your health care provider approves. Diet pills may make heart problems worse.

  • If you have obstructive sleep apnea, manage your condition as told by your health care provider.

  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you:

  • Notice a change in the rate, rhythm, or strength of your heartbeat.

  • Are taking a blood thinner and you notice more bruising.

  • Have a sudden change in weight.

  • Tire more easily when you exercise or do heavy work.

Get help right away if you have:

  • Pain or pressure in your chest.

  • Shortness of breath.

  • Fainting.

  • Increasing sweating with no known cause.

  • Side effects of blood thinners, such as blood in your vomit, stool, or urine, or bleeding that cannot stop.

  • Any symptoms of a stroke. “BE FAST” is an easy way to remember the main warning signs of a stroke:

    • B – Balance. Signs are dizziness, sudden trouble walking, or loss of balance.

    • E – Eyes. Signs are trouble seeing or a sudden change in vision.

    • F – Face. Signs are sudden weakness or numbness of the face, or the face or eyelid drooping on one side.

    • A – Arms. Signs are weakness or numbness in an arm. This happens suddenly and usually on one side of the body.

    • S – Speech. Signs are sudden trouble speaking, slurred speech, or trouble understanding what people say.

    • T – Time. Time to call emergency services. Write down what time symptoms started.

  • Other signs of a stroke, such as:

    • A sudden, severe headache with no known cause.

    • Nausea or vomiting.

    • Seizure.

  • These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • Atrial flutter is an abnormal heart rhythm that can give you symptoms of palpitations, shortness of breath, or fatigue.

  • Atrial flutter is often treated with medicines to keep your heart in a normal rhythm and to prevent a stroke.

  • Get help right away if you cannot catch your breath, or have chest pain or pressure.

  • Get help right away if you have signs or symptoms of a stroke.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.