Atrial Flutter
Atrial flutter is a rapid, organised electrical circuit in an atrium that commonly drives a fast regular or variably conducted pulse.
Key takeaways
- Flutter can cause palpitations, breathlessness, fatigue or light-headedness, but an ECG is needed to distinguish it from other rhythms.
- Clot and stroke prevention generally follows similar risk-based principles to atrial fibrillation.
- Catheter ablation can be particularly effective for typical flutter, while medicines have rate, rhythm or anticoagulation roles.
The listings below are not appropriate for an unidentified fast pulse; treatment depends on ECG pattern, stability and clot risk.
Assessment priorities
Clinicians check blood pressure and symptoms, document the rhythm and look for triggers or associated heart disease. Thyroid dysfunction, lung disease, surgery and alcohol may contribute. Because flutter and atrial fibrillation can coexist, longer rhythm monitoring may be useful.
Rate, rhythm and clot prevention
Rate-controlling medicines slow conduction to the ventricles but do not remove the atrial circuit. Cardioversion can restore rhythm, while ablation targets the circuit in suitable patients. Anticoagulation decisions consider stroke risk and the timing of cardioversion, balanced against bleeding.
When to seek urgent care
Call emergency services for a rapid pulse with fainting, severe chest pain, marked breathlessness, confusion or sudden facial droop, weakness or speech difficulty.