AF Association

Atrial Flutter vs Atrial Fibrillation?

Hello all

Most of the posts talk about A Fib but as I have A Flutter too which I am not aware of when it is happening so please can you tell me (from those of you that have had an ablation) - does it sort the problem for both issues?

Also, I have been prescribed Bisoprolol for the flutter and a flecenaide PIP for the A Fib - is this as expected in your opinion? Still learning about all this?



9 Replies

Flutter is regular but fast and AF is definitely irregular and usually fast too.

The Bisoprolol is to slow down the rate of flutter and or AF and the flecainide is to regulate the irregularity of AF. The other medication you might need to be on is warfarin or one of the newer anticoagulants, other than saying that, it looks as though you are on the right meds.

Coincidentally there was an article on flutter in today's Daily Mail.



Thanks Pat. What about the argument between warfarin and aspirin? I know I would need to get warfarin prescribed and that I can get aspirin over the counter but my cardio originally suggested daily 75mg aspirin which was before he had seen the evidence of my AF. He then said that as I was low risk, there was no evidence to support aspirin and so said I could stop it. What do you think? Surely it is better to keep it going as an anti coagulant if it works.


Tim, I'm not on an anticoagulant either.

I am under an EP and he says I don't need it as my irregular beats only come in short runs(barring my 90 min AF episode in 2012).

I was diagnosed with PAF in 2012 but have had all sorts of undiagnosed 'palpitations' for a number of years(I'm 55 now).

There is a chart I've seen somewhere online, where it works out whether the risk of stroke from an individual's AF/Flutter outweighs the risk of an anticoagulant.

Here it is, it's from NICE.

(btw I choose to take 75mg aspirin daily and have done for ~15 years.)





I have both AF and flutter at different times and had an ablation that was for both. The ablation for the flutter is easier and less risky because of where it is whereas the ablation of the pulmonary veins is more involved as they have to go through the heart wall (with a small risk of a heart bleed).

Hope this helps.



Thanks Jo. Did the ablation sort it out?


OK a number of points here. Flutter is in the right atrium. fibrillation is in the left and they are quite different. In a few cases an EP will do a flutter ablation as he goes through the heart to do an AF one. The ablation for flutter is much easier and many more centres can do it as the EP does not need to breach the septum to get across into the left atrium.

Regarding anti-coagulation, aspirin has no place in stroke prevention for AF. NICE removed it in June 2014. In fact it has no benefit yet can still cause harm by internal bleeding. There are good uses of aspirin in post cardiac infarction or post thrombotic stroke situations but not as a prophylactic. Sadly many doctors still haven't caught up with this development and Pat I'm afraid like many of us you have been wasting your time unless you have other conditions which demand aspirin.

As a relative newby Tim may I point you towards CAREAF where much of this is explained along with risk calculators . Many of us here ignore these and just go for warfarin as stroke is one of our worst nightmares. Forget people who tell you that you are at low risk because your events are few/short/mild whatever. Just having AF makes you 5 times more likely to have a stroke. Read and learn from the data and then make an informed choice.




Thanks Bob!


Flutter can also originate from the left atrium. Usually from op scars......More complicated to ablate. Can be a long procedure.

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