Atrial flutters

[Rachelanx50]

What are atrial flutters??and how do they differentiate from afib???

[Jalia]

Atrial flutter is a fast regular beat, usually showing as a saw tooth pattern on an ECG.It differs from AF in that AF is irregularly irregular in rhythm.

I've had both ( and ablations for each) and personally found AFlutter more troublesome to tolerate as it was unrelenting.

[Cookie24 in reply to Jalia]

Agree, I have had both. Seems like you get some breaks in high rate with afib but not flutter.

[BobD Volunteer]

Atrial flutter emanates from the right atrium and is a fast but regular rhythm . On a 12 lead ECG it shows as a saw tooth line.

Atrial fibrillation is a chaotic non rhythm which can be fast or slow. On ECG typified by lack of P wave.

[valwin in reply to BobD]

Hi Bob what does a saw tooth line look like please.

[BobD Volunteer in reply to valwin]

Picture the teeth on a saw. Zig zggy and even.

[valwin in reply to BobD]

Thank you

[mav7]

Good question !

My question is can someone have both ? Possible, common ?

[Jalia in reply to mav7]

Yes. Certainly. Quite often my AF used to turn to A flutter and then back again to AF. I was in hospital when this happened on at least one occasion.

[Cookie24 in reply to Jalia]

Me too

[wilsond in reply to mav7]

Yes I started out with AFib,then was chemically converted back into NSR after a bad episode,with flecanide,but without a beta blocker to counteract it,and prevent flutter, as recommended A week later , flutter arrived ! So yes you can have both x

[mav7 in reply to wilsond]

Hi wilson

Can you give us a summary of your chemical conversion to NSR ?

Flecanide ? But need beta blocker ? Are you currently in NSR ?

Thanks !

[wilsond in reply to mav7]

HelloIf they give you a hefty dose of flecanide intravenously, in hospital,it's called chemical conversion. I had that apparently as I was nit anticoagulated at the time and I believe you have to be for Cardio version method.

Flecanide can cause flutter without a beta blocker, which it did for me. I guess they forgot or didn't know (!)

This was done by a cardiologist not an Electrophysiologist,and I decided to get referred to one straight away.

I now take 50 mg flec

Am and 150pm with 1.25 biso.

Xx

[wilsond in reply to mav7]

Ps yes most of the time. Get few breakthroughs xx

[Jaggie21 in reply to mav7]

I get both !!

[jimlad2 in reply to mav7]

Yep. . in most of 2013 and 2014 every AF episode I had began with about 90 minutes of flutter - a regular pounding beat that was like a syncopated beat - between where the normal beats would/should have been - before switching to Afib . . In other respects it felt the same as Afib. Hasn't happened since 2014.

[Camille777]

My comments are always to complain, but I don't know if my issues are just with my doctors or doctors in the US, because I didn't even know these terms until I came across this forum or what their definitions were or what they mean. Thank you for clarifying. I get a lot of info here & even more questions to ask. Thanks!

[paulypurplepants]

I never experienced Atrial Flutter until I’d had a CV due to spending a month in AF. A few weeks later I experienced Flutter which was a super fast heart rate showing 170hr on the monitor and just wiped me out. Pleased to say that since reducing my alcohol intake, I’ve had no issues with either. 🤞🏻

[wilsond]

I have both AFib and Afl. Flutter is fast and feels like whirring in my chest. Regular and fast.Fib is quivering but irregular,I don't get fast rate with Fin but most people do

[Ppiman]

I think of the common arrhythmias atrial flutter is the second most frequently seen, but it is still only 1% of the arrhythmias seen by doctors. If you have atrial flutter, the top right of your heart is beating ("fluttering") at around 300bpm, but regularly so; this affects the ventricle's pulse rate in an odd way as it causes it to beat in a stepwise fashion at a rate that is a ratio of the 300bpm, with no smooth gradation between the rates, so the pulse rate with Afl is, for example, 300 (1:1) > 150 (1:2) > 100 (1:3) > 75 (1:4), and so on. 1:1 conduction (300 bpm) is very rare and unsustainable. 1:2, 1:3 and similar (i.e. >100bpm) are classed as tachycardia and must be treated if sustained.

I gather that Afl is the hardest of the two to treat by drugs, but the easiest of the two to treat by ablation. I had mine treated in 2019, successfully. It's also the safest to treat as it occurs on the right top side of the heart (the right atrium), so the doctor does not need to go through the septum of the heart to carry out the ablation; also, the right atrium has no pulmonary veins entering it nor organs pressing against it (i.e. the oesophagus), which can compromise the ablation procedure for AF. This means that almost 100% of ablations for AFl are a success.

Steve

[frazeej in reply to Ppiman]

>>it occurs on the right top side of the heart (the right atrium), so the doctor does not need to go through the septum of the heart to carry out the ablation<<

I'm confused. I previously thought ablations were done via a catheter inserted in the femoral artery in the groin, which would lead to the left ventricle. How does one get to the right atria without going through the septum? I'm a newbie here.

[BobD Volunteer in reply to frazeej]

No ablation is done via an artery. Since all viens lead to the right atrium , a catheter is inserted into the femoral vein and fed up into the right atrium. Any flutter is easily dealt with there but to access the left atrium to ablate for fibrillation the EP has to punch throught the septum (the wall betwen the two chambers). Whilst an angiogram uses arteries to deliver contrast die to the cardiac arteries to check for obstructions, ablation does not.

[frazeej in reply to BobD]

Thank you very much! Certainly clears up my confusion (so I won't appear too much an imbecile when discuss with cardio guy!).

[Ppiman in reply to BobD]

Going into an artery would be impossible I imagine as the blood pressure in there is so high. It’s (usually) the femoral vein.

Steve

[BobD Volunteer in reply to Ppiman]

No they use an artery when doing angiograms. It is just the route they need to take doesn't work with arteries , only veins. I had two angiograms over the years, one through right groin and the last one via right radial artery in wrist.

[Ppiman in reply to BobD]

And hopefully both showed that you were as strong as an ox, Bob!

Steve

[BobD Volunteer in reply to Ppiman]

75% clear so no intervention. The first was at Barts about 35 years ago when my AF journey actually started, the last in 2017 after the DCCV I had stopped my heart and they thought I may have had a heart attack. Scary time but I'm convinced it was due to severe de-hydration. Been nil by mouth for 13 hours! One reason why I bang on about good hydrataion all the time Steve.

[Ppiman in reply to BobD]

You do, but I’m hard to convince on that one since homeostasis is totally central to metabolism and the functioning of the body and the splanchnic bed and colon are repositories containing nigh on a reservoir of good old H2O. That said, quite a number people do have rather inefficient kidneys, so that might be a reason to drink plenty.

The general vibe to carry a bottle of water is pure marketing - Coca-cola, most likely, who saw a gap in the market moons ago.

Steve

[Palpman]

Think of the AV Node as a traffic circle.

The arrhythmia AVNRT or AV Node Reentry Tachycardia is by far the most common Flutter.

This is when the signal from the sinus node reaches the AV node traffic circle then instead of it continuing through to the ventricles some of the charge goes all the way around to pulse the atrials again and to then re enter the circle to go back down to the ventricles and cause another pulse.

This is a snowball effect but organized in its behaviour.

AFib pulses originate from different parts of the left Atrium typically at the pulmonary vein entrances. They are chaotic at the atrials but a bit more organised at the ventricles due to the refractory periods (pauses) at the AV Node. The pulses are not regular.

I hope I'm understood because I don't quite get it myself.

[TracyAdmin Partner]

Hi Rachelanx50, AF and Flutter are have very similar symptoms. For further information, you may be interested in downloading the attached booklet from our patient resources : heartrhythmalliance.org/afa...

booklet