Diagnosis
To diagnose atrial flutter, a healthcare professional examines you and listens to your heart. A member of your care team takes your blood pressure. You usually are asked questions about your symptoms, health habits and medical history.
Tests
You may have tests to check your heart and to look for health conditions that can cause an irregular heartbeat. Tests for atrial flutter may include:
- Lab tests. Blood and urine tests are done to look for health conditions or substances that may affect the heart or heartbeat. If your healthcare team thinks you have atrial flutter, you may have blood tests to check your liver, thyroid and kidneys.
- Electrocardiogram (ECG or EKG). This quick test checks the electrical activity of the heart. It can show how fast or how slow the heart is beating. Sticky patches called sensors attach to the chest and sometimes to the arms or legs. Wires connect the patches to a computer, which displays or prints results.
- Holter monitor. This portable ECG device can be worn for a day or more to record the heart's activity during daily activities.
- Event recorder. This portable ECG device is worn for up to 30 days or until an irregular heartbeat or symptoms occur. You typically press a button when symptoms occur.
- Implantable loop recorder. If irregular heartbeat symptoms don't happen very often, this device may be placed under the skin in the chest area. The device constantly records the heart's electrical activity. It can find irregular heart rhythms.
- Echocardiogram. This test uses sound waves to take pictures of the beating heart. It shows the structure of the heart and heart valves. It also shows how blood flows through the heart.
- Exercise stress tests. These tests often involve walking on a treadmill or pedaling a stationary bike while the heart activity is checked. The tests show how the heart reacts to exercise. If you can't exercise, you may get medicine that increases the heart rate like exercise does. Sometimes an echocardiogram is done during a stress test.
- CT scan of the lungs. You may need this test to check for a blood clot in the lungs, which may cause atrial flutter.
- Electrophysiological (EP) study. This test shows where incorrect heart signals start in the heart. A doctor moves one or more flexible tubes through a blood vessel, usually in the groin, to different areas in the heart. Sensors on the tips of the tubes record the heart's electrical signals.
Treatment
Atrial flutter treatment depends on your overall health and how severe your symptoms are. Treatment may involve medicine or a heart procedure.
Medications
If you have atrial flutter, your healthcare professional may give you medicines to:
- Control the speed of the heartbeat.
- Restore the heart rhythm.
- Prevent blood clots if you also have AFib.
Surgeries or other procedures
If medicine doesn't control atrial flutter, a heart doctor may try to reset your heart rhythm using a procedure called cardioversion.
Cardioversion can be done in two ways:
- Electrical cardioversion. Paddles or patches on the chest send electric shocks to the heart to reset its rhythm. This treatment is commonly used for people with unstable atrial flutter. After electrical cardioversion, you may need medicines to control your heart rhythm for the rest of your life.
- Pharmacologic cardioversion. Medicines given through a vein or by mouth are used to reset the heart rhythm.
Cardioversion usually is done in a hospital as a scheduled procedure. But it may be done in emergency situations.
Radiofrequency ablation is another treatment for atrial flutter. Your heart doctor may suggest this treatment if you have repeated bouts of atrial flutter. But it may be used at other times. The treatment uses thin, flexible tubes called catheters and heat energy to create tiny scars in the heart. Heart signals can't pass through the scars. So the scars block the faulty electrical signals that cause the irregular heartbeat.
Radiofrequency ablation has been shown to improve health-related quality of life for people with atrial flutter.