Atrial flutter occurs when the heart beats too quickly (typically 300 beats per minute) and therefore cannot pump blood efficiently. Atrial flutter that comes and goes is known as paroxysmal atrial flutter. When atrial flutter lasts longer--often for days to weeks at a time--it is called persistent atrial flutter. Left untreated, atrial flutter can lead to an increased risk of stroke.

1. What are the symptoms?

Symptoms can include feeling of fluttering or pounding in the chest (palpitations), shortness of breath, anxiety, weakness or fatigue, angina (chest pain), and/or syncope (fainting).  Some people, however, don't experience any symptoms.

2. What causes atrial flutter?

Causes of atrial flutter include coronary heart disease, myocardial infarction (heart attack), hypertension (high blood pressure), congestive heart failure, heart valve abnormalities, hyperthyroidism and/or lung diseases such as emphysema, chronic bronchitis, or asthma. In addition, some substances can contribute to atrial flutter, including alcohol, cocaine, amphetamines, and cold medicines

3. How is atrial flutter diagnosed?

Those suspected to have an atrial flutter will be referred to an electrophysiologist. At Boston Medical Center, skilled electrophysiologists use several different tests to help diagnose atrial flutter, including:

  • Electrocardiogram. This device tracks and graphs heart rhythm using electrical signals from the heart.
  • Holter monitor. This device monitors and records the heart rhythm continuously for 24-48 hours.
  • Event recorder. An event recorder is activated during episodes of fibrillation and records the heart rhythm at that time.
  • Trans-esophageal echocardiogram. This test produces real-time moving images on a monitor, taken from inside the esophagus and stomach.

4. How is atrial flutter treated?

The goal of treatment for atrial flutter is to control the heart rate and rhythm and to prevent the risk of stroke. To accomplish this, a cardiologist may use medical therapies such as:

Medical treatments (medications)

  • Ablation. This is performed by threading an electrode into the right atrium with a catheter through a vein in the leg. The short circuit, which causes atrial fibrillation, is eliminated by heating the electrode with radiofrequency energy. This cures atrial flutter, and is the most effective treatment for this arrhythmia.
  • Rate control and anticoagulation. These medications help return the heart to its normal rate and prevent clots from forming. A doctor may prescribe rate-control medications, such as beta-blockers, calcium channel blockers, and digitalis, as well as anticoagulation medication such as Coumadin.
  • Anti-arrhythmic drug therapy. Anti-arrhythmic drugs restore normal heart rhythm by slowing the movement of the impulse through heart tissue or lengthening the shortest time possible between two connective beats.

Interventional treatments (medications)

  • Cardioversion. Cardioversion restores normal heart rhythm using a brief electric shock through the chest. Recurrence of atrial flutter after cardioversion alone is common.

Departments and Programs Who Treat This Condition


Arrhythmia Center

The Arrhythmia Center diagnoses and treats all types of abnormal or irregular heart rhythms.

Cardiovascular Center

Our expert, multidisciplinary team offers a wide range of services to both treat and prevent cardiac diseases and conditions. From stents to smoking cessation, we can help you kee…