From the Guidelines
Atrial flutter is a serious condition that can significantly increase the risk of stroke and other cardiovascular complications, and therefore, it is considered bad for your health. According to the 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia, including atrial flutter, antithrombotic therapy is recommended to align with recommended antithrombotic therapy for patients with atrial fibrillation (AF) 1. This is because the risk of stroke associated with atrial flutter is now supported by limited evidence from mechanistic, observational, and prospective studies, and anticoagulation has been shown to prevent stroke when administered during the weeks immediately before and after cardioversion 1. Some key points to consider in the management of atrial flutter include:
- The use of anticoagulants to prevent blood clots and reduce the risk of stroke, with a recommended approach similar to that for patients with AF 1
- The use of medications like beta-blockers or calcium channel blockers to control heart rate, with intravenous amiodarone being an option for acute control of the ventricular rate in patients with systolic heart failure when beta blockers are contraindicated or ineffective 1
- The consideration of procedures like cardioversion or catheter ablation to restore normal rhythm, with the potential risks and benefits being carefully weighed, especially for patients with atrial flutter lasting ≥48 hours who are not adequately anticoagulated 1. Overall, atrial flutter is a condition that requires prompt medical attention and treatment to prevent serious complications and improve quality of life.
From the Research
Definition and Treatment of Atrial Flutter
- Atrial flutter is a type of arrhythmia characterized by a rapid but regular heartbeat 2.
- Treatment for atrial flutter often involves rate control using medications such as beta-blockers or non-dihydropyridine calcium channel blockers [(3,4,5)].
Effectiveness of Treatment Options
- Studies have shown that diltiazem, a calcium channel blocker, is more effective than metoprolol, a beta-blocker, in achieving rate control in patients with atrial fibrillation or flutter 3.
- The combination of intravenous calcium channel blockers and beta-blockers can be effective in achieving rate control in patients with rapid atrial fibrillation or flutter 4.
Risks and Adverse Outcomes Associated with Atrial Flutter
- Atrial flutter is associated with an increased risk of adverse outcomes, including atrial fibrillation, myocardial infarction, heart failure, stroke, and mortality 2.
- Clinical risk factors for atrial flutter include smoking, increased PR interval, myocardial infarction, and heart failure 2.
Management of Atrial Flutter in Specific Patient Populations
- In patients with acute decompensated heart failure, the use of non-dihydropyridine calcium channel blockers and beta-blockers for rate control is a topic of ongoing debate 6.
- Beta-blockers have been shown to have mortality benefits in patients with chronic heart failure with reduced ejection fraction 6.