Atrial Flutter
Disease Description
Atrial flutter is an atrial tachyarrhythmia characterized by a rapid and regular atrial contraction rate of approximately 250–350 beats per minute.
Causes of the Disease
The development of atrial flutter involves the re-entry mechanism of electrical excitation within the atria. The clinical presentation, symptoms, and even treatment strategies are largely similar to those observed in atrial fibrillation.
Symptoms
Patients with atrial flutter experience symptoms similar to those seen in atrial fibrillation, including weakness and general malaise, reduced exercise tolerance, palpitations, shortness of breath, and irregular heartbeats.
Some patients may also experience chest pain or episodes of fainting. In all such cases, consultation with a qualified cardiac electrophysiologist is strongly recommended to reduce the risk of serious complications, including stroke.
Diagnosis
At our Center for Cardiac Surgery and Interventional Cardiology, patients can undergo comprehensive diagnostic evaluation and, if atrial flutter is detected, receive appropriate treatment.
Atrial flutter is diagnosed based on clinical findings, electrocardiography (ECG) recorded during an episode, or results of 24-hour (Holter) ECG monitoring. Implantable electronic devices — such as pacemakers, implantable cardioverter-defibrillators (ICDs), and subcutaneous ECG monitors — also play an important role in diagnosis by automatically detecting rhythm disturbances and providing valuable data to the physician.
Treatment
Treatment of atrial flutter includes the use of medications aimed at preventing arrhythmic episodes and reducing the risk of stroke.
Therapy should be comprehensive and include management of coexisting conditions such as heart failure or arterial hypertension.
If antiarrhythmic drug therapy is ineffective, radiofrequency catheter ablation (RFA) may be performed.
In cases of so-called typical atrial flutter, where the arrhythmia mechanism can be reliably identified based on ECG findings, the effectiveness of RFA may reach 90% or higher. After successful ablation, long-term use of antiarrhythmic medications is often no longer required.
Treatment Prognosis
Atrial flutter — whether symptomatic or asymptomatic — is associated with increased risks of hospitalization, progression of heart failure, stroke, and overall mortality.
Radiofrequency catheter ablation of the atrial flutter substrate is highly effective and, in most cases, permanently eliminates episodes of rapid heart rhythm.