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Atrial Flutter

Atrial Flutter Exams and Tests continued...

People sometimes have symptoms suggesting atrial flutter, but their ECG result in the emergency department or medical office is normal.

  • This does not necessarily mean that you are "imagining things." It may mean that your arrhythmia comes and goes, a very common condition. It may also mean you just have some premature beats, which is not dangerous.
  • If this happens to you, you may be asked to undergo an ambulatory ECG.
  • The purpose of an ambulatory ECG is to get documentation of whether you do or do not have a significant arrhythmia and what type.
  • This is important because you cannot receive treatment until your specific arrhythmia type has been identified.

Ambulatory ECG involves wearing a monitoring device for a few days while you go about your normal activities.

  • The device, also known as a Holter monitor, is usually worn around your neck. ECG electrodes are worn on the chest.
  • Typically, the device records your heart rhythm on a continual basis for 24-72 hours.
  • Some health care providers prefer that you wear the device for a longer time, with intermittent recording of your heart rhythm. This is called an event recorder, which you can turn on when you feel something abnormal. More rarely, an event recorder can be implanted under the skin and worn for several weeks or months.
  • Either method works well. The important thing is to get ECG documentation of your arrhythmia.

Echocardiogram: This is a painless ultrasound test that uses sound waves to make a picture of the inside of the heart while it is beating and between beats.

  • This test is done to identify heart valve problems, check ventricular function, or look for blood clots in the atria.
  • This very safe test uses the same technique used to check a fetus in pregnancy.
  • This test is not always done in the emergency department.

Occasionally, atrial flutter is detected in people with no symptoms when they are seeing their health care provider about something else. The health care provider may notice unusual heart sounds or pulse on physical exam and perform an ECG.

Atrial Flutter Treatment

The goals of treatment for atrial flutter are to control the heart rate, restore normal sinus rhythm, prevent future episodes, and prevent stroke.

Control rate: The first treatment goal is to control the ventricular rate.

  • If you experience serious symptoms, such as chest pain or congestive heart failure related to the ventricular rate, the health care provider in the emergency department will decrease your heart rate rapidly with IV medications or electrical shock (called cardioversion or defibrillation).
  • If you have no serious symptoms, you may be given medications by mouth.
  • Sometimes you may require a combination of oral drugs to control your heart rate.
  • Surgery may be done to control heart rate or rhythm, but this is rare.

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