Atrial Flutter
Atrial flutter is a rapid, organised heart rhythm problem where the upper chambers of the heart beat at around 250 to 350 times per minute, typically causing the lower chambers to beat at half that rate. The result is a fast but regular pulse that can feel like a persistent flutter or racing in the chest. It is closely related to atrial fibrillation but has a more predictable, circuit-like pattern.
Key points
- The upper chambers race at 250 to 350 beats a minute while the lower chambers typically follow at about half that rate.
- Many people describe only a faint sense of their heartbeat, though others feel considerably unwell during an episode.
- Antiarrhythmic treatment with flecainide can help hold a normal rhythm once the acute episode is over, alongside cardioversion or ablation for resistant cases.
Recognising the rhythm and when to act
Common symptoms include palpitations, shortness of breath, reduced exercise tolerance, and light-headedness. Some people notice little beyond an unusual awareness of their heartbeat; others feel markedly unwell. Atrial flutter raises the risk of blood clots forming in the heart, so anyone experiencing a sudden racing pulse, chest tightness, or fainting should seek prompt medical attention.
Restoring and maintaining normal rhythm
Treatment aims to slow the ventricular rate, restore sinus rhythm, and reduce clot risk. Medicines from the heart and blood pressure category are central to management. Antiarrhythmic agents such as flecainide may be used to maintain normal rhythm after the acute episode has been addressed. Electrical cardioversion and catheter ablation are also established options when long-term rate control proves difficult.