From the Guidelines
Atrial flutter is primarily caused by an abnormal electrical circuit in the heart's right atrium, often triggered by underlying heart disease conditions, hypertension, hyperthyroidism, chronic lung diseases, and other factors that disrupt normal electrical pathways. The causes of atrial flutter can be multifactorial, including:
- Heart disease conditions such as coronary artery disease, heart valve problems, cardiomyopathy, and previous heart surgery which can create scarring that disrupts normal electrical pathways 1
- Hypertension, which causes structural changes to the heart over time 1
- Hyperthyroidism, which increases heart rate 1
- Chronic lung diseases like COPD that put strain on the heart 1
- Excessive alcohol consumption, stimulant use including caffeine, cocaine, and certain medications, electrolyte imbalances, and sleep apnea 1
- Age, with atrial flutter becoming more common after age 60 1
- Inflammation of the heart (myocarditis or pericarditis) can trigger atrial flutter, as can acute illnesses or surgeries that stress the cardiovascular system 1
- Some people may have a genetic predisposition to developing this arrhythmia 1
It is essential to note that atrial flutter can occur in clinical settings similar to those associated with atrial fibrillation, and the two conditions can coexist in the same patient 1. Management typically involves rate control medications, anticoagulation to prevent stroke, and often catheter ablation to eliminate the abnormal electrical circuit 1.
The most recent and highest quality study, 1, provides the most comprehensive understanding of the causes of atrial flutter, highlighting the importance of considering multiple factors when diagnosing and managing this condition.
From the Research
Causes of Atrial Flutter
The causes of atrial flutter are not explicitly stated in the provided studies, but several risk factors and associated conditions are mentioned.
- Atrial fibrillation, a related condition, has several risk factors, including:
- Atrial flutter is often associated with similar clinical contexts to atrial fibrillation, although the embolic risk may be smaller 2.
- Atypical atrial flutter is a heterogenous group of re-entrant atrial tachycardias that most commonly occur in patients with prior heart surgery or catheter ablation 6.
- The presence of a slow-conducting isthmus, localized re-entry, dual-loop re-entry or bystander loops may lead to misleading activation maps but can be identified by electrogram examination and entrainment mapping 6.