Stephen J. Schueler, M.D.

Overview Incidence Risk Factors Symptoms Evaluation Treatment anticoagulation cardioversion catheter ablation drugs questions for doctor specialist Home Care diet pulse check warning signs Complications Underlying Cause Anatomy

Flutter Atrial Treatment

Treatment for atrial flutter focuses on reducing the rapid heart rate, or converting the atrial flutter to a normal sinus rhythm. During treatment, blood thinners may be given, in order to reduce the risk for a stroke by preventing blood clots from forming in the heart. Medications or electrical cardioversion reset atrial flutter to a normal sinus rhythm. During electrical cardioversion, the heart is subjected to a small electrical shock, delivered through paddles, or patches, placed on the skin over the chest. The electrical current interrupts the atrial flutter rhythm, allowing the normal heartbeat to take over. After cardioversion, medications maintain the normal rhythm. Although the conversion to a normal rhythm may occur quickly, ongoing treatment with medication may be required for months or years.

If medication or cardioversion do not convert the heart o a normal rhythm, then the doctor may recommend radiofrequency catheter ablation or the Maze procedure. During radiofrequency ablation, a special catheter is threaded through the bloodstream and to the heart. The catheter is used to deliver radio waves, which destroy the tiny region of heart cells that are responsible for the abnormal rhythm.

Treatment for atrial flutter may include:

  • Medications for atrial flutter
  • Blood thinners:
  • Cardioversion: an electrical current resets the heart rhythm:
    • May be performed with paddles
    • May be performed via internal defibrillator
    • May be performed through special pacemaker
  • Radiofrequency catheter ablation:
    • Tiny electrical burns in the heart muscle reset the heart rhythm

Flutter Atrial Anticoagulation

Rarely, atrial flutter can cause blood clots to form in the chambers of the heart. The clot can break off of the wall of the heart chamber, where it is carried through arteries by the bloodstream. As the artery becomes smaller and smaller, eventually the clot becomes stuck in the artery. This completely stops blood from flowing to the tissues supplied by the artery. The most common place that this occurs is in the brain, where the clot causes a stroke. Anticoagulant medications reduce the risk of clot formation.

Anticoagulant medications:

Flutter Atrial Cardioversion

Paddle Cardioversion
Electrical cardioversion may be used to treat atrial flutter. Cardioversion introduces a brief electrical current to the heart, through the chest wall. The electric current is delivered through metal electrodes that are attached to the surface of the chest. The procedure resets the heart's own pacemaker, which converts the atrial fibrillation to a normal rhythm.

Internal Cardioversion
An internal automatic cardiac defibrillator may also be used to perform cardioversion in those who have recurrent atrial flutter. This is a small device that is placed inside the chest, like a pacemaker. The defibrillator can deliver a brief electric current when it senses atrial fibrillation.

Pacemaker Cardioversion
Some cardiac pacemakers also have built-in defibrillator capability, allowing for cardioversion when the heart rate or rhythm becomes abnormal. Pacemakers are electronic devices that regulate the heart rate within a normal range.

Flutter Atrial Catheter Ablation

Radiofrequency catheter ablation may be used to treat atrial flutter in those who do not respond to treatment with medication or electrical cardioversion. During this procedure, a thin catheter is inserted in a blood vessel and the end is threaded into the heart. The catheter tip can generate electrical current and heat. The cardiologist performing the procedure uses the catheter to make pinpoint burns in the tissue on the inside surface of the heart. The pinpoint burns interrupt the electric signals from the tissue that cause atrial flutter. About 80 to 90 percent of people are cured after this procedure.

Flutter Atrial Drugs

Flutter Atrial Questions For Doctor

The following are some important questions to ask before and after the treatment of atrial flutter.

Questions to ask before treatment:

  • What are my treatment options?
    • Is surgery an option for me?
  • What are the risks associated with treatment?
  • Do I need to stay in the hospital?
    • How long will I be in the hospital?
  • What are the complications I should watch for?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • Do I need to change my diet?
  • Are there any medications or supplements I should avoid?
  • When can I resume my normal activities?
  • When can I return to work?
  • Do I need a special exercise program?
  • What else can I do to reduce my risk for cardiac arrhythmias?
  • How often will I need to see my doctor for checkups?
  • What local support and other resources are available?

Flutter Atrial Specialist

Physicians from the following specialties evaluate and treat atrial flutter:

Continue to Flutter Atrial Home Care

Last Updated: Jun 2, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
Copyright DSHI Systems, Inc. Powered by: FreeMD - Your Virtual Doctor

PubMed Flutter Atrial References
  1. Ghali WA, Wasil BI, Brant R, Exner DV, Cornuz J. Atrial flutter and the risk of thromboembolism: a systematic review and meta-analysis. Am J Med. 2005 Feb;118(2):101-7. [15694889]
  2. Lee KW, Yang Y, Scheinman MM; University of Califoirnia-San Francisco, San Francisco, CA, USA. Atrial flutter: a review of its history, mechanisms, clinical features, and current therapy. Curr Probl Cardiol. 2005 Mar;30(3):121-67. [15711509]
  3. Mead GE, Flapan AD, Elder AT. Electrical cardioversion for atrial fibrillation and flutter. Cochrane Database Syst Rev. 2002;(1):CD002903. [11869642]
  4. Waldo AL. Mechanisms of atrial flutter and atrial fibrillation: distinct entities or two sides of a coin? Cardiovasc Res. 2002 May;54(2):217-29. [12062328]
FreeMD is provided for information purposes only and should not be used as a substitute for evaluation and treatment by a physician. Please review our terms of use.