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    Atrial Flutter

    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.

    Atrial Flutter Medications

    The choice of medication depends on the frequency of atrial flutter, the underlying cause, your other medical conditions and overall health, and the other drugs you take. The classes of medications used in atrial flutter are as follows:

    • Anti-arrhythmic medications: These drugs are used to chemically convert atrial flutter to normal sinus rhythm, reduce the frequency and duration of atrial flutter episodes, and prevent future episodes. They are often given to prevent return of atrial flutter after cardioversion. Examples are amiodarone, sotalol, ibutilide, propafenone, and flecainide.
    • Digoxin (Lanoxin): This drug decreases the conductivity of electrical impulses through the SA and AV nodes, slowing down the heart rate.
    • Beta-blockers: These drugs decrease the heart rate by slowing conduction through the AV node, plus they have a direct anti-arrhythmic effect on the atria.
    • Calcium channel blockers : These drugs also slow down the heart rate by slowing conduction through the AV node.
    • Anticoagulants: These drugs reduce the ability of the blood to clot, thus reducing the risk of an unwanted blood clot forming in the heart or in a blood vessel. Atrial flutter increases the risk of forming such blood clots.

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