Atrial flutter

Dr. med. Andrea Reiter is a freelance writer for the medical editorial team.

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Atrial flutter is a cardiac arrhythmia that usually occurs with heart disease or drug therapy. Those affected suffer from palpitations, shortness of breath and dizziness. Atrial flutter can be cured in over 95 percent of cases. Read all about the cause and treatment of atrial flutter.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. R00I48I46I47I49I45I44

Atrial flutter: description

Atrial flutter is a rhythm disturbance that originates in the right atrium of the heart. In the case of atrial flutter, the electrical signal from the sinus node “loses its path” and creates so-called circling excitations in the right atrium. This stimulates the atria up to 300 times per minute. The electrical signals are also passed on to the heart chambers. In the conduction system of the heart, however, there is a protection (a so-called block by the AV node) against excessive excitation. Only every second, third or fourth signal is actually passed on to the muscle cells of the chambers. The heart then beats up to 150 times per minute.

Sometimes this blockage exposes the electrical excitation. Then so many excitations are passed on to the heart chambers that they beat at a rate of up to 300 per minute. Those affected then quickly pass out.

Atrial flutter: symptoms

Since the heart beats very quickly with atrial flutter (more than 150 times per minute), those affected almost always feel an uncomfortable palpitations and palpitations. You feel tired, breathless, and dizzy. Many feel pressure on their chests. The rhythm disturbance usually starts suddenly. The pulse is fast and regular.

Atrial flutter: causes and risk factors

Most atrial flutter occurs when the heart is weakened from coronary artery disease, inflammation, or after heart surgery. Very rarely, atrial flutter can arise without a specific trigger.

Atrial flutter: diagnosis and examination

In most cases, it is sufficient for the doctor to do what is known as an electrocardiogram (EKG). The heart currents are derived from electrodes that are placed on the chest and recorded by a recorder. Sometimes the EKG needs to be written over a period of 24 hours or more to document the atrial flutter.

Depending on how the circulating excitations run, there is typical atrial flutter or atypical atrial flutter. Typical atrial flutter is visible in the EKG through a "sawtooth-like" image of the heart currents.

If the atrial flutter cannot be diagnosed with an EKG, a so-called electrophysiological examination can be carried out. It is similar to a heart catheter examination. Here, an electrode catheter is advanced through an inguinal vein to the heart. It measures the electrical excitation directly on the heart. If atrial flutter is found in the examination, it can be treated during the examination.

Atrial flutter: treatment

Atrial flutter can be stopped for a while by a so-called electrocardioversion. This therapy method is similar to defibrillation during resuscitation. First, two so-called electrodes are stuck to the patient's chest. The patient is then anesthetized. The doctor uses the electrodes to conduct a brief electric shock through the patient's heart. Due to the power surge, it usually falls back into the right rhythm. All vital parameters of the patient are monitored. After a cardioversion, however, the atrial flutter usually returns after a while.

If the atrial flutter occurs more frequently, a so-called catheter ablation can cure the affected person. For this purpose, an electrode catheter is passed over the inguinal vein to the heart. The area where the atrial flutter develops can be obliterated via the catheter. The cure rate with this treatment method is more than 95 percent.

Atrial flutter: disease course and prognosis

In almost all cases, catheter ablation can cure the atrial flutter. However, the prognosis is particularly dependent on the heart disease that triggered the atrial flutter.

Atrial flutter is only sometimes dangerous when the excitations are passed one-to-one into the ventricles. Atrial flutter rarely changes into what is known as atrial fibrillation after medication has been administered.

Since atrial flutter increases the risk of stroke, those affected often have to be given blood-thinning medication. If an ablation was successful, blood-thinning treatment for atrial flutter is usually no longer necessary.

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