Dr. M.J. Bazos, MD
Patient
Handout
ATRIAL
FLUTTER
About Your
Diagnosis
In atrial flutter, the atria
of the heart begin to beat in a rapid rhythm because of too many abnormal
electrical impulses. The atria may beat up to 300 times per minute. About one
half to one fourth of these impulses are passed down to the ventricles. Most of
the time this phenomenon is not felt; sometimes there is a feeling of a rapid
heartbeat (palpitations). A number of illnesses can cause atrial flutter. Heart
or lung disease, thyroid disease, or heart valve disorders are predisposing
factors for atrial flutter.
Living
With Your Diagnosis
When the atrium is
fluttering it is attempting to contract, but the contractions are too fast. The
ventricles contract when signaled and beat fast. This abnormal rhythm of the
heart is an arrhythmia. This rhythm is considered unstable but may revert
to normal spontaneously, or it may convert to atrial fibrillation (a more
irregular atrial arrhythmia). Because the ventricles are not filling with blood
normally, they must work harder to supply blood to the body. This may eventually
cause angina (heart pain caused by a reduction in blood supply to the heart
muscle) or heart failure (decreased pumping efficiency of the heart). Symptoms
of heart failure are difficulty breathing, chest pain, or fainting. Atrial
flutter is diagnosed by a particular pattern on an electrocardiogram (ECG). The
motion of the atrium may be evaluated with an echocardiogram, which is an
ultrasound examination of the heart. This examination also can show whether
there are blood clots in the
atrium.
Treatment
Therapy
for atrial flutter focuses on the cause of the arrhythmia. While the cause is
being sought or treated, acute management of the flutter depends on the symptoms
and the suspected cause. Heart disease, for example, should be managed, but the
flutter may not revert to normal. The flutter can be treated with digitalis
(digoxin) to help control the rate at which the ventricles contract. Digitalis
also helps make the contractions more efficient. Digoxin therapy often is begun
in the hospital so that the level of drug in the blood stream and changes in
heart rhythm can be monitored. If digoxin therapy continues outside the
hospital, the level of the medicine in the blood has to be checked from time to
time. If clots have formed in the atrium, administration of anticoagulants such
as warfarin (eg, Coumadin) may be started. This medicine can cause easy bruising
or bleeding, and levels have to be checked periodically. Sometimes the abnormal
rhythm of the heart caused by atrial flutter is electrically shocked to normal.
This procedure is called cardioversion. Medicines to manage thyroid,
heart, or lung disease are taken as directed to avoid prolonged atrial flutter
or fibrillation. Other prescribed medications, should be taken regularly, and
levels should be monitored on
schedule.
The
DOs
•Stop
smoking.
•Reduce your intake of
alcohol and caffeine.
•Eat a diet for
that is healthful for your heart. Decrease fat and cholesterol
intake.
•Lose weight if you are
overweight.
•Reduce stress in your
life as much as possible, because stress may worsen your
symptoms.
•Exercise to your level of
tolerance if you are taking the proper medications and have no
symptoms.
The
DON’Ts
•Avoid activities
that cause bruising if you are taking
anticoagulants.
•Do not forget to
take your usual medications.
When to
Call Your Doctor
•If you have
side effects from your medications or if you have new or worsening symptoms.
These include chest pain, shortness of breath or difficulty breathing, fainting,
palpitations, or sudden changes in the ability to speak, eat, walk, or use your
limbs.
•If you are taking
anticoagulants and sustain a serious cut or head injury.