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www.atrialfibrillation-au.org Atrial Flutter

Atrial fl utter is a disturbance of the rhythm and atrial flutter () where the upper chambers of the Both atrial fl utter and atrial fi brillation can heart (atria) beat very rapidly. The atria are increase the risk of stroke. The abnormal heart responsible for the control of the heart rate, so rhythm causes the blood to pool in the upper this usually results in your becoming fast chambers and this may cause the blood to clot. and often regular. A person may not feel any This clot can then be carried to the small blood symptoms when the heart rhythm changes from vessels in the brain where it blocks the blood fl ow normal rhythm to atrial fl utter – it may only be and causes a stroke. To reduce this risk of stroke detected during a visit to a doctor for other your doctor will assess your personal risk factors. reasons. However, some people may present with Depending on your level of risk he or she will : (being able to feel the heart beating), discuss whether to start you on a blood thinning , chest pain and tiredness or Atrial Flutter - Patient Information medication such as , dabigatran, fatigue. They may also experience occasional rivaroxaban or . feelings of dizziness or light-headedness. People who have fl utter, may at other times have Specific treatment of atrial flutter another arrhythmia called atrial fi brillation (see the AF-A patient information sheet, Atrial There are diff erent ways to treat atrial fl utter and fi brillation). There are many similarities between these are often used in combination. these two conditions, but also some important diff erences. Both can cause the heart rate to : This is the conversion of an increase causing a rapid pulse. With fl utter, the abnormal heart rhythm to normal rhythm. pulse is often regular. In fi brillation the pulse This can occasionally be accomplished by becomes irregular. The pulse tends to be faster medications. With atrial fl utter electrical (DC) with fl utter compared with fi brillation. cardioversion is usually required (see the AF-A patient information sheet, Cardioversion) under The basic problem in atrial fl utter is that an a general anaesthetic or sedation. Cardioversion electrical impulse becomes trapped in a circle does not prevent recurrence of fl utter. of tissue in the heart, most commonly in the right upper heart chamber (right ), and goes : Often this treatment is around this circuit at a very rapid rate with considered if atrial fl utter recurs following a transmission at a slower rate to the main pumping cardioversion. Sometimes, your doctor may chambers (ventricles). A heart rhythm recording even recommend a catheter ablation as the fi rst (electrocardiogram or ECG) is necessary to treatment, rather than undertaking cardioversion. diagnose atrial fl utter (see the AF-A booklet, The The procedure involves passing wires (catheters) heart, the pulse and the ECG). There are many into the heart, usually via the groin or neck veins. diff erent causes of atrial fl utter, including: One of these wires is then used to apply heat • Older age or cold (ablation) to a small area of the heart to • High blood pressure (“”) prevent atrial fl utter recurring. This is a simple and • Alcohol highly eff ective treatment for the most common • Disease of the heart valves type of atrial fl utter but not all fl utter circuits are • amenable to ablation therapy. • Overactive thyroid gland • Lung disease Sometimes there is no obvious cause.

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AF-A Australia Medical Advisory Committee: Dr Michael Davis Professor Ben Freedman Dr Gerry Kaye Founder & CEO: Mrs Trudie Lobban MBE Deputy CEO: Mrs Jo Jerrome

1 AF Association Australia Tel: 1800 050 267 or (02) 61084602 info@atrialfi brillation-au.org www.atrialfi brillation-au.org AF A

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Medication: Medication (such as beta blockers, calcium channel blockers or , sometimes in combination) can be used either to slow the heart rate without actually stopping the fl utter. This approach is less successful for atrial fl utter than for atrial fi brillation.

An antiarrhythmic drug (see the AF-A booklet, Drug information) may be recommended to prevent further attacks of atrial fl utter. A heart rate slowing medication as above may be required in combination with the antiarrhythmic Atrial Flutter - Patient Information medication.

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® www.aa-international.org www.afa-international.org Affiliate Affiliate The Cardiac Society of Australia and New Zealand

AF-A Australia Medical Advisory Committee: Dr Michael Davis Professor Ben Freedman Dr Gerry Kaye Founder & CEO: Mrs Trudie Lobban MBE Deputy CEO: Mrs Jo Jerrome © AF Association Published January 2009, Reviewed July 2013, Planned Review Date July 2018 This factsheet has been adapted for AF Association Australia with kind permission from the AF Association www.afa.org.uk Please remember that this publication provides general guidelines only. Individuals should always discuss their condition with 2 a healthcare professional. If you would like further information or would like to provide feedback please contact AF-A.