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February 7, 2012
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Atrial Flutter

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Atrial Flutter Overview

Atrial flutter is an abnormality of the heart rhythm, resulting in a rapid and sometimes irregular heartbeat. Such abnormalities, whether in the rate or regularity of the heartbeat, are known as arrhythmias.

The beating of the heart is controlled by electrical impulses.

  • Under normal circumstances, these impulses are generated by the heart's natural pacemaker, the sinoatrial (SA) or sinus node, which is located in the right atrium.
  • The impulse travels across the atria, generating a contraction of the atria.
  • The impulse pauses very briefly at the atrioventricular (AV) node, which is located in the upper part of the muscular wall between the two ventricles. This delay gives the blood time to move from the atria to the ventricles.
  • The impulse then moves down and through the ventricles, generating the ventricular contraction, which pumps the blood out of the ventricles.

Atrial flutter occurs when these electrical impulses take an abnormal path through the atria, typically circulating around the tricuspid valve in the right atrium.

  • The abnormal path of the impulses makes the atria contract very rapidly, typically about 250-350 beats per minute. The normal heart rate is 50-100 beats per minute.
  • These rapid contractions are slowed when they reach the AV node often with every second or third contraction reaching the ventricle.
  • The heart beats in a regular rhythm, but it beats rapidly.
  • This type of rhythm is called tachycardia (rapid heartbeat). Because atrial flutter comes from the atria, it is sometimes called a supraventricular (above the ventricles) tachycardia.
The main danger of atrial flutter is that the heart does not pump blood well when it is beating too fast. When blood is not pumped well, vital organs, such as the heart and brain, may not get enough oxygen from the blood.

Atrial flutter can come and go; it is then known as paroxysmal atrial flutter. More often, atrial flutter lasts for days to weeks and is known as persistent atrial flutter.

With proper treatment, atrial flutter is rarely life- threatening. Complications of atrial flutter, in particular stroke, can be devastating, but they can be prevented with medications ("blood thinners") such as warfarin (Coumadin).

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Atrial Flutter

Heart Rhythm Disorders Overview

The primary function of the heart is to supply blood and nutrients to the body. The regular beating, or contraction, of the heart moves the blood throughout the body. Each heartbeat is controlled by electrical impulses traveling through the heart. In the normal heart these electrical impulses occur in regular intervals. When something goes wrong with the heart’s electrical system, the heart does not beat regularly. The irregular beating results in a rhythm disorder, or arrhythmia.

The electrical system regulating heartbeat consists of 2 main areas of control and a series of conducting pathways, similar to the electrical wiring in a house (See Multimedia File 1).

  • The sinoatrial, or SA, node is located in the right atrium. It provides the main control and is the source of each beat. The SA node also keeps up with the body's overall need for blood and increases the he...

Read the Heart Rhythm Disorders article »


Read What Your Physician is Reading on Medscape

Atrial Flutter »

Atrial flutter has many clinical aspects that are similar to atrial fibrillation(ie, underlying disease, predisposing factors, complications, medical management).

Read More on Medscape Reference »

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