About-Cardio
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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Atrial Flutter (AV Flutter)
Introduction
Atrial flutter (AV flutter) is a type of supraventricular tachycardia (SVT) that originates in the atria. It is characterized by a rapid and regular atrial rate, typically around 250–350 beats per minute (bpm), while the ventricular rate may be slower due to the AV node's filtering effect.
Causes and Risk Factors
Atrial flutter is often associated with:
- Structural heart disease (e.g., ischemic heart disease, cardiomyopathy, valvular disease)
- Hypertension
- Chronic lung disease (e.g., COPD)
- Hyperthyroidism
- Post-cardiac surgery
- Excessive alcohol or stimulant use
Symptoms
Patients with atrial flutter may experience:
- Palpitations
- Fatigue
- Dizziness or syncope
- Shortness of breath
- Chest discomfort Some patients may remain asymptomatic.
Diagnosis
The diagnosis is primarily made with an Electrocardiogram (ECG). Features of atrial flutter on ECG include:
- Sawtooth pattern of atrial waves (best seen in leads II, III, aVF)
- Atrial rate of 250–350 bpm
- Fixed AV conduction ratio (e.g., 2:1, 3:1, or 4:1 blocks)
- Regular ventricular response if conduction is stable
Treatment Options
Treatment depends on the patient’s stability and underlying conditions:
1. Acute Management
- Unstable patients (hypotension, severe symptoms): Immediate electrical cardioversion (typically 50–100 J synchronized shock).
- Stable patients:
- Rate control: Beta-blockers (e.g., metoprolol) or non-dihydropyridine calcium channel blockers (e.g., diltiazem, verapamil) to slow ventricular response.
- Rhythm control: Medications like amiodarone or dofetilide to restore sinus rhythm.
- Anticoagulation: Risk assessment using the CHA₂DS₂-VASc score to prevent stroke.
2. Long-Term Management
- Catheter ablation is often the preferred treatment for recurrent atrial flutter.
- Long-term medications (e.g., antiarrhythmic drugs) may be required in some cases.
- Management of underlying conditions such as heart failure or thyroid disorders.
Conclusion
Atrial flutter is a serious arrhythmia that requires appropriate management to prevent complications like stroke and heart failure. If you or a loved one experiences palpitations, dizziness, or unexplained fatigue, seek medical attention promptly.
Source recommendations
1. American Heart Association (AHA) Guidelines on Arrhythmias
- https://www.heart.org/en/health-topics/arrhythmia
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
- https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
- https://pubmed.ncbi.nlm.nih.gov/29097294/
2. European Society of Cardiology (ESC) Guidelines for the Management of Supraventricular Arrhythmias
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Supraventricular-Tachycardia
- https://academic.oup.com/eurheartj/article/41/5/655/5556821
- https://pubmed.ncbi.nlm.nih.gov/14557344/
- https://www.ahajournals.org/doi/10.1161/01.cir.0000091380.04100.84
- https://pubmed.ncbi.nlm.nih.gov/14563598/
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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