Atrial Flutter

The atria (upper chambers of the heart) beat faster than the ventricles (lower chambers of the heart).  It is usually an irregular heart rhythm caused by abnormal circuits in the electrical system. Atrial flutter can sometimes degenerate into atrial fibrillation.

Atrial arrhythmias are more common in congenital heart diseases that cause the top chambers of the heart to enlarge. Conditions such as atrial septal defects after surgical repair, Tetralogy of Fallot, classic and lateral tunnel Fontan circuits, and transposition of the great arteries after Senning/Mustard repair. Leaking of the valves that separate the atria from the ventricles can cause the atria to become large over time, and increase the risk of atrial arrhythmias.

Symptoms and Signs

The symptoms of atrial arrhythmias vary, ranging from no symptoms at all to:

  • shortness of breath
  • palpitations (heart racing, skipping, or fluttering feelings)
  • dizziness
  • fatigue

If the atrial arrhythmia is not under control, weakening of the heart muscle and/or blood clot formation in the heart can occur, increasing the risk of stroke.


Most of the time a 12 lead ECG can determine if you are in atrial flutter. In rare cases you may receive a medication called Adenosine to help make an accurate diagnosis.


Management of atrial flutter and/or fibrillation is directed at controlling fast heart rates that can lead to symptoms and overall weakening of the heart muscle and avoiding blood clots that can lead to stroke. A variety of cardiac medications and blood thinners may also be prescribed by your cardiologist. On occasion, a cardioversion (a controlled electrical shock while under sedation) may be necessary to restore a patient’s normal rhythm. In select patients either an electrophysiology study (EPS) and catheter ablation or surgical ablation (see Basic EP Fact Sheet) can be used to treat the problem and cauterize the sites of abnormal electrical discharges. Your cardiologist will discuss the treatment options with you.

Lifestyle Changes

Ongoing close management with your cardiologist/electrophysiologist is essential. Depending on rhythm control and medical management, lifestyle changes may be individualized.

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