Atrial Flutter: Causes, Diagnosis, and Treatment

Atrial Flutter is a type of arrhythmia caused by abnormal electrical activity in the upper chambers of the heart. Timely assessment and treatment is essential to reduce the risk of cardiovascular complications, including stroke, heart failure, and clotting.  

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What is Atrial Flutter?

Atrial Flutter, also known as AFL, is a type of cardiac arrhythmia in which a person has an abnormally fast but consistent heartbeat. The condition is caused by electrical impulses in the heart that result in the atria (upper chambers) beating faster than the ventricles (lower chambers), causing the heartbeat to increase around 300 times per minute instead of a normal 60-90 beats. 

Unlike some irregular heart rhythm disorders, atrial flutter produces a rapid yet organised rhythm pattern. Even so, the condition can affect blood circulation and place additional strain on the heart over time. 

How is Atrial Flutter Different from Atrial Fibrillation?

Atrial Flutter and Atrial Fibrillation are closely related rhythm disorders. They may share similar symptoms and complications, but they are actually different heart conditions.

Atrial Flutter: The atria beat abnormally fast but regularly, usually around 300 times per minute.

Atrial Fibrillation: The atria beat fast and irregularly, and the rhythm becomes more chaotic.

Some patients can experience both conditions at different times, particularly those with underlying heart disease or previous cardiac procedures.

Symptoms of Atrial Flutter

  • Rapid but steady heartbeat
  • Chest discomfort (heaviness, tightness, and pain)
  • Palpitations or fluttering sensations in the chest
  • Dizziness or light-headedness
  • Shortness of breath, especially during physical activity
  • Unexplained and persistent fatigue

What Causes Atrial Flutter?

Atrial flutter develops when abnormal electrical impulses circulate continuously within the atria. It can occur without any obvious reason in a healthy heart or may be associated with underlying cardiovascular conditions or age-related electrical changes within the heart. The condition becomes increasingly common after the age of 50. 

Several medical conditions may contribute to flutter disease, including:

Types of Atrial Flutter

Typical Atrial Flutter

Around 90% patients experience typical atrial flutter. It occurs in the right atrium, where electrical signals move in an anticlockwise direction. 8This form often responds very well to catheter ablation and can frequently be treated with a minimally invasive outpatient procedure. 

Atypical Atrial Flutter

Comparatively less common and occurs in the left atrium. The electrical pathways in atypical atrial flutter are more complex and can be treated with catheter ablation, but the procedure can be longer.

Our Specialists’ Diagnostic Approach to AFL

Atrial flutter can occur intermittently, tehhrefore, diagnosis sometimes may requires prolonged heart rhythm monitoring to capture abnormal episodes. At The National Heart Clinic, our specialists provide a comprehensive cardiac rhythm assessment using advanced diagnostic technology. Investigations may include:

  • Electrocardiogram (ECG): Provides a snapshot of your heart’s electrical activity.
  • Echocardiogram (Heart Ultrasound): Examines the cardiac structure and function.
  • Ambulatory Holter Monitoring: A portable ECG that provides continuous heart monitoring for a set period. 
  • Stress ECG: Determines how well your heart responds to physical stress.
  • Electrophysiology Study (EPS): A specialised procedure to map the heart’s electrical system and determine the precise source of abnormal signals. 
  • Blood Tests: Help identify contributing conditions such as thyroid dysfunction, inflammation, or electrolyte imbalance.
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Atrial Flutter Treatment in London

Lifestyle Changes

  • Reduce alcohol and caffeine intake
  • Stop smoking
  • Improve blood pressure control
  • Manage sleep apnoea
  • Maintain a healthy weight
  • Increase physical activity safely under medical guidance
  • Medicines to manage arrhythmia, restore normal rhythm, and prevent blood clots.

Medication

Medicines may be prescribed to:

  • Restore normal rhythm
  • Reduce recurrence of episodes
  • Slow the heart rate
  • Prevent blood clotting and stroke risk

Catheter Ablation

Catheter ablation is considered one of the most effective long-term treatments for atrial flutter. During the procedure, thin catheters are guided into the heart to target and interrupt the abnormal electrical pathway responsible for the arrhythmia.

Atrioventricular (AV) Node Ablation

In difficult-to-control arrhythmias, AV node ablation combined with pacemaker therapy is usually recommended.

Cardioversion

Cardioversion uses a carefully controlled electrical impulse to restore a normal heart rhythm. It is commonly recommended for persistent atrial flutter episodes.

When to Seek Urgent Care?

Atrial Flutter is often treatable with early diagnosis and the right treatment. However, if you experience one or more of the following symptoms, its improtant to seek urgent medical advice:

  • Chest pain or pressure
  • Dizziness or fainting
  • Breathlessness
  • You have an existing heart condition, such as heart failure or COPD

Why Choose The National Heart Clinic?

Our experienced cardiology specialists provide comprehensive assessment, advanced diagnostic testing, and personalised treatment plans to help patients receive the right care.

Early diagnosis and expert cardiology care can help identify the underlying cause of your symptoms and support effective long-term management.

  • Flexible appointments
  • Specialist Atrial Flutter treatment
  • Comprehensive diagnostics with state-of-the-art facilities

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Book an appointment with a cardiac consultant at The National Heart Clinic, Harley Street, London, and get expert assessment, accurate diagnosis, and a personalised treatment plan to manage your symptoms effectively.

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Atrial Flutter can increase the risk of serious complications if left untreated, including stroke, heart failure, and blood clots. Patients usually respond well to early diagnosis and specialist treatment. However, symptoms such as chest pain, severe breathlessness, collapse, fainting, or sudden sweating should be considered a medical emergency.

Family history, previous heart surgery, hypertension, obesity, or old age can increase the likelihood of developing Atrial flutter. Certain health conditions, including diabetes, sleep apnea, thyroid disorders, or COPD, can also increase your risk of AFL.

Many people with atrial flutter can live healthy and active lives with lifestyle adjustments and long-term management plan. Proper care can help control symptoms and reduce recurrence risk.

Atrial Flutter often show a ‘sawtooth’ appearance on an electrocardiogram (ECG) with the heart rate commonly between 250 and 320 beats per minute.

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