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Atrial Flutter

Atrial Flutter Treatment continued...

Restore and maintain normal sinus rhythm: Some people with newly diagnosed atrial flutter convert to normal sinus rhythm spontaneously in 24-48 hours. The goal of treatment is to convert the atrial flutter to normal sinus rhythm and prevent recurrence of atrial flutter.

  • Not everyone with atrial flutter needs anti-arrhythmic medication.
  • The frequency with which your arrhythmia returns and the symptoms it causes partly determine whether you receive anti-arrhythmic drugs.
  • Medical professionals carefully tailor each person's anti-arrhythmic medication(s) to produce the desired effect without creating unwanted side effects, some potentially lethal.

Prevent future episodes: This is usually done by taking daily medication to keep the heart at a safe and comfortable rate.

Prevent stroke: Stroke is a devastating complication of atrial flutter. It occurs when a piece of a blood clot formed in the heart breaks off and travels to the brain, where it blocks blood flow.

  • Coexisting medical conditions, such as congestive heart failure and mitral valve disease, significantly increase the risk of stroke.
  • Patients with persistent atrial flutter need a "blood-thinning" drug called warfarin to lower this risk. Warfarin blocks a certain factor in the blood that promotes clotting. Other blood thinners called Pradaxa (dabigatran), Eliquis (apixaban), and Xarelto (rivaroxaban) have been approved by the FDA to prevent stroke in people with atrial fibrillation.
  • People at lower risk of stroke and those who cannot take warfarin may use aspirin. Aspirin is not without its own side effects, including bleeding problems and stomach ulcers.

Atrial Flutter Care at Home

Most people known to have atrial flutter will be taking prescribed drugs. Avoid taking any stimulants, and consult with your health care provider before taking any new medications, herbs, or supplements.

Medical Treatment for Atrial Flutter

The first step in treatment is to restore normal rate and sinus rhythm. There are two ways to do this, with medication or with defibrillation.

Defibrillation: This technique uses electrical current to "shock" the heart back to normal sinus rhythm. This is sometimes called "DC cardioversion."

  • This is done by applying a device called an external defibrillator to the chest.
  • This device uses the paddles familiar to watchers of television medical dramas.
  • When this is done in a hospital, usually a mild general anesthetic is given first because the electrical shocks are painful.
  • Cardioversion works very well; more than 90% of people convert to sinus rhythm. For some, however, this is not a permanent solution; the arrhythmia comes back.
  • Cardioversion increases the risk of stroke and thus, if time allows, requires pretreatment with a blood thinning drug.

Catheter ablation (radiofrequency ablation): "Ablation" means removal. This technique inactivates the abnormal conduction pathways in the right atrium.

  • The abnormal pathway(s) is found, and a catheter is placed at this precise location in the conduction system.
  • After proper placement, the catheter delivers radiofrequency energy, which burns ("ablates") a portion of the abnormal electrical conduction pathway. This inactivates the abnormal pathway to provide more consistent flow of electrical impulses.
  • This technique is low risk; it works in some people but not all. It has few complications and, unlike surgery, requires little recovery time.

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