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Learning About Atrial Flutter

Right and left atria of heart, with example of EKG reading of atrial flutter

What is atrial flutter?

Atrial flutter is a type of abnormal heartbeat (arrhythmia). Normally, the heart beats in a steady rhythm. In atrial flutter, a problem with the heart's electrical system causes the upper parts of the heart (atria) to beat very fast, or flutter.

An episode of atrial flutter is not typically dangerous. But atrial flutter can lead to serious problems. During an episode, blood can collect, or pool, in the atria making it more likely to form blood clots. Clots can travel to the brain, block blood flow, and cause a stroke. Over time, atrial flutter can also lead to weakening the heart's pumping function (heart failure).

Atrial flutter is often caused by another heart condition, such as coronary artery disease or heart valve problems. It may happen after heart surgery.

Most people with atrial flutter are able to live full and active lives.

What are the symptoms?

Some people have symptoms when they have episodes of atrial flutter. But other people don't notice any symptoms.

If you have symptoms, you may feel:

  • A fluttering, racing, or pounding feeling in your chest (palpitations).
  • Weak or tired.
  • Dizzy or light-headed.
  • Short of breath.
  • Chest pain.

You may notice signs of atrial flutter when you check your pulse. Your pulse may seem fast.

How is atrial flutter treated?

Treatments can help you feel better and prevent future problems, especially stroke and heart failure.

The main types of treatment slow the heart rate, stop atrial flutter, and help prevent stroke. Your treatment may depend on the cause of your atrial flutter, your symptoms, your risk for stroke, and your preferences. Treatment options include:

  • Medicines to slow your heart rate. They may also help relieve your symptoms. Or you may take a medicine to try to stop the flutter from happening.
  • Blood-thinning medicines to help prevent stroke. You and your doctor can decide if you will take medicine to lower your risk.
  • Electrical cardioversion to stop atrial flutter. This short procedure involves an electric current used to shock the heart back to a normal rhythm. There’s a chance that the atrial flutter may come back.
  • Catheter ablation to stop atrial flutter. This short procedure involves thin wires that are passed through a vein to the heart. These are used to destroy the areas of heart tissue that are causing atrial flutter. After a successful ablation, the atrial flutter should not come back.

How can you care for yourself at home?

  • Be safe with medicines.
    • Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
    • If your doctor has given you a blood thinner to prevent a stroke, be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.
    • Do not take any over-the-counter drugs or natural health products without talking to your doctor first.
  • Have a heart-healthy lifestyle.
    • Try to quit or cut back on using tobacco and other nicotine products. This includes smoking and vaping. Smoking can increase your chance of a stroke and heart attack. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good. Try to avoid second-hand smoke too.
    • Eat heart-healthy foods. These include vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit sodium and sugar.
    • If you drink, try to drink less. Your risk of harm from alcohol is low if you have 2 drinks or less per week. Work with your doctor to find what is best for you.
    • Stay at a weight that's healthy for you. Talk to your doctor if you need help losing weight.
    • Try to get 7 to 9 hours of sleep each night.
    • Manage other health problems such as high blood pressure, high cholesterol, and diabetes. If you think you may have a problem with alcohol or drug use, talk to your doctor.
    • Avoid infections such as COVID-19, colds, and influenza (flu). Get the flu vaccine every year. Get a pneumococcal vaccine shot. If you have had one before, ask your doctor whether you need another dose. Stay up to date on your COVID-19 vaccines.
  • Be active, but be safe.
    • Talk to your doctor about what type and level of exercise is safe for you. Try to be physically active for at least 2½ hours a week. For many people, walking is a good choice. You also may want to swim, bike, or do other activities.
    • When you exercise, watch for signs that your heart is working too hard. You are pushing too hard if you can't talk while you exercise. If you become short of breath or dizzy or have chest pain, sit down and rest right away.
  • Talk with your healthcare provider about feelings such as worry, anxiety, or depression related to your heart condition. These feelings are normal and getting help is an important part of your overall health.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have symptoms of a stroke. These may include:
    • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
    • Sudden vision changes.
    • Sudden trouble speaking.
    • Sudden confusion or trouble understanding simple statements.
    • Sudden problems with walking or balance.
    • A sudden, severe headache that is different from past headaches.
  • You passed out (lost consciousness).

Call your doctor or nurse advice line now or seek immediate medical care if:

  • You have new or increased shortness of breath.
  • You feel dizzy or light-headed, or you feel like you may faint.
  • You have an episode of atrial flutter and your doctor wants you to call when you have one.
  • You have new or worse symptoms.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

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