Atrial Flutter

In a normal heart beat, or normal sinus rhythm, an electrical impulse originates at the SA node which is located in the upper right atrium.  This electrical impulse travels through the atria to the AV node where there is a brief pause.  The AV node then transfers the electrical impulse to the ventricles which completes a heart beat.

Atrial flutter is an atrial arrhythmia in which a single irritable site in the atria initiates many electrical impulses at a rapid rate.  The atria beat at rates of 250-400 beats per minute. In atrial flutter, the ventricular rate is slower than the atrial rate, with the rate depending upon the number of impulses conducted through the AV Node to the ventricles.  In atrial flutter the ventricular rate is typically regular. In atrial fibrillation the ventricular rate is typically irregular due to rapid firing of multiple irritable sites in the atria. 

Treatment options for atrial flutter are pharmacologic, cardioversion, and/or catheter ablation.  Initially, a cardiologist will look to control the ventricular rate of atrial flutter pharmacologically.  Beta blockers, calcium channel blockers or digitalis may be utilized for rate control.  A cardiologist may elect to utilize a cardioversion if medications are unsuccessful at converting atrial flutter to normal sinus rhythm.  Another treatment option for atrial flutter is catheter ablation which is performed by a cardiologist that specializes in treatments of electrical disorders of the heart.  This type of cardiologist is called an electrophysiologist. 

Causes of atrial flutter include valvular heart disease, acute MI, high blood pressure, cardiomyopathy, pulmonary disease, pulmonary emboli, congestive heart failure, pericarditis, and myocarditis.