atrial flutter

Atrial flutter: description

Atrial flutter is a rhythm disorder that originates from the right atrium of the heart. In atrial flutter, the electrical signal of the sinus node “comes off the path” and forms so-called circular excitations in the right atrium. This stimulates the atria up to 300 times per minute. The electrical signals are also forwarded to the heart chambers. However, in the cardiac conduction system there is protection (a so-called block through the AV node) from too rapid excitations. Only every second, third or fourth signal is actually passed on to the muscle cells of the chambers. The heart beats then up to 150 times per minute.

Sometimes this blockage of electrical excitations stops. Then so many excitations are transmitted to the ventricles that they beat at a rate of up to 300 per minute. Those affected quickly become unconscious.

Atrial flutter: symptoms

Since the heart beats very fast in atrial flutter (more than 150 times per minute), those affected almost always feel an unpleasant palpitation and heart palpitations. You feel tired, breathless and dizzy. Many feel a pressure on the chest. The arrhythmia usually starts suddenly. The pulse is fast and regular.

Atrial flutter: causes and risk factors

Most often, atrial flutter occurs when the heart is weakened by coronary heart disease, inflammation, or cardiac surgery. Very rarely, the atrial flutter can arise without a special trigger.

Atrial flutter: diagnosis and examination

In most cases it is sufficient if the doctor makes a so-called electrocardiogram (ECG). Via electrodes placed on the chest, the heart currents are drawn off and recorded by a recorder. Sometimes the ECG needs to be written for a period of 24 hours or more to document atrial flutter.

Depending on how the circling excitement proceeds, there is typical atrial flutter or atypical atrial flutter. Typical atrial flutter becomes visible on the ECG by a “sawtooth” image of the cardiac currents.

If the atrial flutter can not be diagnosed by an ECG, a so-called electrophysiological examination can be carried out. It is similar to a cardiac catheterization. Here, an electrode catheter is advanced over a veined vein to the heart. He measures the electrical impulses directly at the heart. If atrial flutter is detected during the examination, it can still be treated during the examination.

Atrial flutter: treatment

Atrial flutter can be stopped by a so-called electrocardioversion for a while. This therapy is similar to defibrillation during resuscitation. First, two so-called electrodes are glued to the patient’s chest. Afterwards anesthetize the patient. About the electrodes, the doctor conducts a short electric shock through the heart of the patient. Due to the current surge, it usually falls back into the right rhythm. All vital parameters of the patient are monitored. However, after cardioversion atrial flutter usually returns after some time.

If the atrial flutter occurs more frequently, so-called catheter ablation can heal those affected. An electrode catheter is guided over the inguinal vein to the heart. Through the catheter, the area where the atrial flutter develops can be obliterated. The cure rate for this treatment method is more than 95 percent.

Atrial flutter: Disease course and prognosis

In almost all cases, the atrial flutter can be cured by catheter ablation. However, the prognosis is particularly dependent on the heart disease that triggered the atrial flutter.

The atrial flutter is only sometimes dangerous when the excitement is forwarded one to one in the chambers. Rarely does atrial flutter jump after medication into a so-called atrial fibrillation.

Since the risk of stroke is increased in atrial flutter, those affected often have to receive blood-thinning medications. If an ablation has been successful, a blood thinning treatment is included atrial flutter mostly not necessary anymore.