Atrial flutter is the second most common type of heart rhythm disorder after atrial fibrillation. The condition has no specific symptoms and is difficult to recognize until it becomes more severe.
1. What is atrial flutter?
Atrial flutter occurs when the atria of the heart begin to beat faster due to an excessive number of abnormal electrical impulses. The atria flutter as they attempt to contract, but this contraction occurs at a rate that is too fast. The atria can beat up to 300 times per minute, compared to the normal range of 60 to 100 times per minute.
2. Risk factors for atrial flutter
Atrial flutter is common in older adults. Generally, the rate of men having a higher risk of atrial flutter than women.
Factors that increase the risk of atrial flutter include:
- Age: Older adults have a higher risk than usual;
- Medical history: Individuals with a history of cardiovascular disease, heart valve problems, a history of myocardial infarction, and heart surgery;
- Hypertension: If not well-controlled, patients can have an increased risk of atrial flutter;
- Alcohol addiction;
- Family history of atrial flutter.
3. Causes of atrial flutter.
Atrial flutter has many causes, mainly heart-related conditions such as:
- Hypertension
- Myocardial infarction
- Heart valve abnormalities
- Congenital heart defects
- Hyperthyroidism
- After open-heart surgery
- After major non-cardiac surgery
- After congenital heart defect repair surgery
4. Symptoms of atrial flutter
The main signs of atrial flutter are palpitations, dizziness, lightheadedness, fainting, and sudden changes in the ability to speak, eat, walk, or move limbs.
Other signs may include chest pain or heart failure. When experiencing chest pain, the patient will feel pain in the heart, which is due to a reduced blood supply to the heart.
Additionally, in cases with heart failure symptoms, patients may encounter respiratory issues or fainting.
5. Diagnosis of atrial flutter
The diagnosis of atrial flutter is based on medical history, physical examination, and electrocardiography (ECG). The ECG provides insight into the heart’s conduction system and helps confirm the diagnosis:
- Based on F waves on the ECG
- Regular sawtooth pattern
- Most evident in II, III, aVF
- F(+) in V1, V2
- F(-) in V5, V6
- Similar to solitary P waves in the precordial leads
- Counterclockwise atrial flutter F(-) in II, III, aVF, V6 and F(+) in V1
- Clockwise atrial flutter F(+) in II, III, aVF, and often has a notch.
Additionally, an echocardiogram may also be performed. This procedure will show the movement of the atria and detect whether there are any blood clots in the atria.
Doctors may also recommend tests to rule out other conditions. Additionally, they may perform X-rays to assess the condition of the lungs and heart.
6. Treatment of Atrial Fibrillation
The primary goal of treatment is to address the underlying cause of the heart rhythm disorder while slowing the heart rate and preventing the formation of blood clots to maintain a normal heartbeat. The treatment method depends on the symptoms and causes of the condition. Some medications will help control the contraction frequency of the ventricles to restore the heart’s normal rhythm. This method is also known as medication cardioversion.
If medications are ineffective or if the patient has more severe symptoms, the doctor may proceed with electrical cardioversion. That brief electric shock will stop the heart’s electrical activity to restore a normal heartbeat.
If these methods are not effective, the doctor will suggest the use of electrophysiological study (EPS). Based on the results of the EPS analysis, the doctor will decide on other treatment options such as: radiofrequency ablation, pacemaker placement, and surgery.
7. Preventive Measures for Atrial Fibrillation
The following lifestyle habits and practices will help limit the progression of atrial fibrillation:
- Follow up as scheduled for monitoring the progression of the disease and your health status.
- Follow the doctor’s instructions; do not take medications not prescribed or skip medications from the prescription provided to you.
- Quit smoking.
- Limit the use of alcoholic substances
- Consume heart-healthy foods, minimize fat intake
- Lose weight if you are overweight
- Reduce stress
