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    Atrial Flutter

    Atrial Flutter Exams and Tests continued...

    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.

    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.

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