Heart Health Center

Atrial Flutter

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.

Next Steps and Beyond

Atrial flutter increases your risk of having a stroke.

• When the heart is not pumping properly, some blood may be left behind in the heart. This blood forms a pool and is more likely to clot than blood that is moving.
• A piece of a blood clot in the heart can break off and travel to the brain. There, it can block a blood vessel, causing a stroke.

The other serious complication of atrial flutter is heart failure.

• Rapid beating of the heart over a long time can weaken the heart muscle. This further impairs its pumping ability.
• When the heart can no longer pump enough blood to the body through the blood vessels, this is called heart failure.

If you experience atrial flutter and are found to have no underlying heart disease, your outlook is generally quite good. If it occurs once without serious heart or lung disease, most likely you will never have it again. If you do have underlying heart disease, your atrial flutter may recur. Therefore, you should see a heart specialist (cardiologist).

Multimedia

Media file 1: A 12-lead electrocardiogram demonstrating atrial flutter.