Materiały źródłowe

• #1 Treatment of atrial flutter | Heart

  https://heart.bmj.com/content/84/2/227

  After atrial fibrillation, atrial flutter is the most important and most common atrial tachyarrhythmia. […] The past 25 years have produced major changes. […] Blockers and calcium channel blockers are now available for use as an adjunct to or in lieu of digitalis treatment to control the ventricular response rate. […] New antiarrhythmic agents are available for use to suppress atrial flutter or convert it to sinus rhythm. […] Catheter ablation techniques either to cure atrial flutter or to control the ventricular response rate have been developed, and related surgical treatments are available. […] Even automatic low energy cardioversion of atrial flutter to sinus rhythm has been developed.

• #2 Atrial Flutter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK540985/

  Atrial flutter, a supraventricular arrhythmia, is one of the most common rhythm disturbances of the heart. This activity outlines the evaluation and treatment of atrial flutter and highlights the role of the interprofessional team in managing patients with this condition. […] Treatment management should focus on the following aspects: Rhythm control, Rate control, Anticoagulation due to embolization risk. […] Maintenance of the sinus rhythm or conversion of the sinus rhythm is essential. […] There are different ways to achieve sinus rhythm: electrical cardioversion, pharmacological cardioversion, and catheter ablation. […] In the acute setting, in patients with atrial flutter who are hemodynamically unstable, synchronized cardioversion is indicated for the conversion of sinus rhythm to stabilize the patient.

• #2 Atrial Flutter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK540985/

  In stable patients, pharmacological cardioversion is achievable with different antiarrhythmics. […] Despite the multiple pharmacological options, controlling and converting atrial flutter to sinus rhythm is difficult. […] In the presence of a new diagnosis of atrial flutter, one should start the patient on anticoagulation. […] Patients who have a contraindication to these drugs or do not tolerate them may consider catheter ablation of the atrial flutter circuit. […] Radiofrequency catheter ablation of the CTI is the standard treatment for typical atrial flutter with a success rate of 95% and few complications post-procedure. […] Rate control is achievable using atrioventricular nodal agents such as calcium channel blockers (first line) or beta blockers. […] Patients with atrial flutter have a similar risk of strokes as those with atrial fibrillation. […] The prognosis of patients with typical atrial flutter undergoing catheter ablation is good, with a recurrence rate of less than 5%.

• #3 Atrial Flutter Treatment & Management: Approach Considerations, Ventricular Rate Control, Electrical Cardioversion

  https://emedicine.medscape.com/article/151210-treatment

  General treatment goals for symptomatic atrial flutter are similar to those for atrial fibrillation and include the following: Control of the ventricular rate […] Restoration of sinus rhythm […] Prevention of recurrent episodes or reduction of their frequency or duration […] Prevention of thromboembolic complications […] Minimization of adverse effects from therapy. […] The main difference between atrial fibrillation and atrial flutter is that most cases of atrial flutter can be cured with radiofrequency ablation (RFA). In all available studies, catheter ablation is superior to rate-control and rhythm-control strategies with antiarrhythmic drugs. […] Consider catheter-based ablation as first-line therapy in patients with typical atrial flutter if they are reasonable candidates. […] Given its high success rate and low complication rate, RFA is superior to medical therapy. Successful ablation reduces or eliminates the need for long-term antiarrhythmic medications and anticoagulation (unless the patient also has atrial fibrillation).

• #3 Atrial Flutter Treatment & Management: Approach Considerations, Ventricular Rate Control, Electrical Cardioversion

  https://emedicine.medscape.com/article/151210-treatment

  For atrial flutter duration shorter than 48 hours, attempt cardioversion as soon as possible. […] For episodes of atrial flutter of uncertain duration or longer than 48 hours, begin anticoagulation therapy. Rate control and therapeutic anticoagulation are required for a minimum of 4 weeks prior to cardioversion. […] In patients who are not candidates for catheter-based ablation, rate- and rhythm-control strategies should be considered. […] Preferred medications that slow atrioventricular (AV) node conduction include beta blockers (eg, atenolol, metoprolol, propranolol, landiolol) and calcium channel blockers (eg, verapamil, diltiazem). […] Considering anticoagulation in this patient population (at least until sinus rhythm is maintained) is a wise decision. Anticoagulant therapy (ie, warfarin) is indicated, especially when the atrial flutter is longer than 48 hours’ duration or its onset is uncertain.

• #3 Atrial Flutter Treatment & Management: Approach Considerations, Ventricular Rate Control, Electrical Cardioversion

  https://emedicine.medscape.com/article/151210-treatment

  Although many patients treated with RFA have subsequently developed atrial fibrillation on long-term follow-up, this procedure still represents a safe alternative to antiarrhythmic agents. […] After the initial episode of atrial flutter is terminated and the underlying disease is treated, the patient may not need any further intervention except avoidance of the precipitating factor (eg, alcohol). For atrial fibrillation, approximately 30% of patients remain in sinus rhythm at 1 year without antiarrhythmic therapy, and the situation may be similar with atrial flutter. […] If intervention is required, always consider catheter-based ablation before starting an antiarrhythmic agent. Radiofrequency ablation is currently the preferred therapeutic choice.

• #4 Atrial Flutter | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/atrial-flutter

  Over the past decades, UCSF has helped pioneer breakthroughs in the understanding and treatment of arrhythmias, or heart rhythm disorders, such as atrial flutter. […] The most commonly used treatment, catheter ablation, was first performed on humans here in 1981. This minimally invasive procedure, which uses radio-frequency waves to disable the electrical pathways causing the arrhythmia, has a success rate of about 97 percent. […] Depending on the type and severity of your arrhythmia, and the results of various tests including the electrophysiology study, there are several treatment options. You and your doctor will decide which one is right for you. […] Certain anti-arrhythmic drugs change the electrical signals in the heart and help prevent abnormal sites from starting irregular or rapid heart rhythms.

• #4 Atrial Flutter | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/atrial-flutter

  An implantable cardioverter defibrillator is a device for people who are prone to life-threatening rapid heart rhythms. […] The U.S. Food and Drug Administration (FDA) recently approved the first of a new type of pacemaker that paces both ventricles of the heart to coordinate their contractions and improve their pumping ability.

• #5 Treatment for Atrial Flutter | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/atrial-flutter/treatments.html

  Treatments can help you feel better and prevent future problems, especially stroke and heart failure. […] The main types of treatment slow the heart rate and help prevent stroke. Your treatment will depend on the cause of your atrial flutter, your symptoms, and your risk for stroke. Treatments include: […] Medicines to slow your heart rate. They may also help relieve your symptoms. Or you may take a medicine to try to stop the flutter from happening. […] Blood-thinning medicines to help prevent stroke. You and your doctor can decide if you will take medicine to lower your risk. […] Electrical cardioversion to stop atrial flutter. An electric current is used to shock the heart back to a normal rhythm. […] Catheter ablation to stop atrial flutter. Thin wires are used to send energy to destroy the tiny areas of heart tissue that are causing atrial flutter.

• #6 Atrial Flutter: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22885-atrial-flutter

  Atrial flutter treatment may begin with treating the condition that caused it. Treatment for atrial flutter itself includes medications and procedures. […] Medicines work well for many people with atrial flutter. Any medicine can have side effects, but the benefits usually are greater than the risks. When medicines dont work, your provider may recommend a procedure that can help. […] Medicines for the treatment of atrial flutter include drugs that: Slow down your heart rate (calcium channel blockers and beta-blockers), Stop the abnormal rhythm (antiarrhythmic drugs), Prevent blood clots (anticoagulants). […] Procedures to treat atrial flutter include: Cardioversion using medicine or electrical shock, Catheter ablation, a procedure a provider can use to destroy the tissue thats creating abnormal signals, Temporary change in your pacemaker or implantable cardioverter defibrillator (ICD) setting.

• #6 Atrial Flutter: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22885-atrial-flutter

  Cardioversion works in 70% to 90% of people. Some people have less than a 5% chance of atrial flutter happening again after a catheter ablation. Others may have less successful procedures because of their type of atrial flutter. People with complex cases of atypical atrial flutter may have only a 70% success rate with ablation. […] After having an ablation, you can expect to have some limits for the first week. This means waiting a week before you drive a vehicle or lift more than 10 pounds. […] A heart rhythm thats too fast can make you feel uneasy. But your healthcare provider can help you with treatments for atrial flutter. These treatments may lower your risk of a stroke or heart failure. That’s why it’s important to keep your appointments with your provider. They can figure out your risk of stroke and offer solutions to get your heart rhythm back to normal. Your provider can help you decide which treatment is best for your situation.

• #7

  https://myhealth.alberta.ca/Alberta/Pages/atrial-flutter-treatment.aspx

  Your treatment choices depend mainly on: […] Most often, treatment includes medicine that either keeps your heart in a normal rhythm or keeps your pulse at a normal rate (under 100 bpm) while the atria are in atrial flutter. […] To prevent a blood clot from forming in your heart, you may be started on a blood thinner medicine. […] If the atrial flutter cant be managed well with medicine, your cardiologist may recommend that you have an electrical cardioversion done. […] In some cases, you will be referred to see another cardiac specialist called an electrophysiologist. […] One of these treatments is an invasive procedure called an ablation. […] Its important to talk with your doctor about your arrhythmia and treatment options if youve been diagnosed with atrial flutter. […] Even if you have no symptoms while in atrial flutter, you may still be prescribed medicine because of the risk of stroke.

• #8 Medical Therapy for Atrial Fibrillation & Atrial Flutter | NYU Langone Health

  https://nyulangone.org/conditions/atrial-fibrillation-atrial-flutter/treatments/medical-therapy-for-atrial-fibrillation-atrial-flutter

  When lifestyle changes alone are not enough to control atrial fibrillation (AFib) or atrial flutter, cardiac electrophysiologists at NYU Langones Heart Rhythm Center may prescribe medication to slow your heart rate, control its rhythm, and prevent a life-threatening stroke. […] If medication therapy is not effective, your doctor may recommend cardioversion or catheter ablation. […] Your cardiologist may prescribe antiarrhythmic medications, beta blockers, or calcium channel blockers to control the hearts rhythm and rate. […] Antiarrhythmic medications can control electrical impulses to the heart, thus encouraging a healthy rate and rhythm. […] Medications such as amiodarone, flecainide, Multaq, and sotalol are commonly used for these purposes. […] Beta blockers can lower your heart rate by inhibiting the effects of stress hormones, such as adrenaline, on the heart and blood vessels.

• #8 Medical Therapy for Atrial Fibrillation & Atrial Flutter | NYU Langone Health

  https://nyulangone.org/conditions/atrial-fibrillation-atrial-flutter/treatments/medical-therapy-for-atrial-fibrillation-atrial-flutter

  Calcium channel blockers, such as verapamil, relax the walls of blood vessels and slow your heart rate. […] Anticoagulants or antiplatelet medications may be prescribed to prevent these clots. […] Anticoagulants, such as Coumadin, Eliquis, Xarelto, and Pradaxa, affect the bloods ability to clot. […] Antiplatelet medications prevent plateletsblood cells involved in clot formationfrom clumping together. […] Aspirin is a commonly prescribed antiplatelet medication. […] If you are unable to tolerate the side effects of these medications, your doctor might recommend you receive a left atrial appendage occlusion device, which limits the ability of clots to form in the heart.

• #9 Atrial Flutter: Types, Symptoms, Causes, Tests, and Treatments

  https://www.webmd.com/heart-disease/atrial-fibrillation/atrial-flutter

  Different types of medications may be prescribed for atrial flutter. […] Drugs to slow your heart rate: Calcium channel blockers, Beta-blockers, Digoxin. […] Drugs to restore a normal heart rhythm: Amiodarone, Dofetilide, Flecainide, Propafenone, Quinidine, Sotalol. […] These treatments are sometimes called chemical cardioversion. They can restore a normal rhythm, but they can have significant side effects and are less effective than a cardioversion procedure. Only about 50% to 60% of people who take them will respond. […] Drugs to prevent blood clots: Apixaban, Dabigatran, Enoxaparin, Heparin, Rivaroxaban, Warfarin. […] Cardioversion. Doctors use electrical shocks to convert your heart from atrial flutter to a normal rhythm. This is effective for about 75% to 90% of people. […] Catheter ablation. In this procedure, a thin, flexible tube called a catheter is inserted into a blood vessel and moved to your heart. Once there, your doctor will use the catheter to deliver hot or cold energy to make scars in the part of your heart where your atrial flutter occurs. These scars block the abnormal electrical signals that cause atrial flutter so that your heart can beat normally. Ablation is the only treatment that can cure atrial flutter or significantly reduce the number of episodes you have.

• #10 Atrial Flutter: Symptoms, Causes, Treatment & Life Expectancy

  https://www.emedicinehealth.com/atrial_flutter/article_em.htm

  If no serious symptoms have occurred, the person may be given medications by mouth. […] Sometimes, a combination of oral medications is required to control the heart rate. […] In some people, an invasive procedure called radiofrequency catheter ablation may provide long-term successful treatment, and no additional medications may be needed. […] Restore and maintain a normal rhythm: Some people with newly diagnosed atrial flutter convert to a normal rhythm spontaneously in 24-48 hours; however, the atrial flutter may recur. […] Prevention of future episodes: Prevention usually involves taking daily medication to keep the heart in a normal rhythm. […] Stroke prevention: Stroke is a devastating complication of atrial flutter. […] Most people with atrial flutter, including all people older than 65 years, should take a blood-thinning drug called warfarin (Coumadin) to lower this risk.

• #10 Atrial Flutter: Symptoms, Causes, Treatment & Life Expectancy

  https://www.emedicinehealth.com/atrial_flutter/article_em.htm

  The choice of medication depends on the underlying cause, other medical conditions and overall health, and other medications being taken. […] Miscellaneous anti-arrhythmia medications: They reduce the frequency and duration of atrial flutter episodes and thus can prevent future episodes. […] Anticoagulants: These drugs reduce the ability of the blood to clot, thus reducing the risk of an unwanted blood clot forming in the heart or in a blood vessel.

• #11 Atrial Flutter – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/atrial-flutter

  Atrial flutter is a rapid regular atrial rhythm due to an atrial macroreentrant circuit. […] Treatment involves rate control with medication, prevention of thromboembolism with anticoagulants, and often conversion to sinus rhythm with medication, cardioversion, or atrial flutter substrate ablation. […] Treatment of atrial flutter focuses on ventricular rate control, rhythm control, and prevention of thromboembolism. […] Pharmacologic rate control is more difficult to achieve in atrial flutter than in atrial fibrillation. […] Typically, low-energy (50 joules) conversion is effective. Anticoagulation, as in atrial fibrillation, is necessary before cardioversion. […] Ablation procedures designed to interrupt the atrial reentrant circuit may effectively prevent atrial flutter, particularly typical atrial flutter.

• #11 Atrial Flutter – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/atrial-flutter

  To prevent thromboembolism, patients with chronic or recurrent atrial flutter require an oral anticoagulant (warfarin titrated to an INR of 2 to 3, a direct thrombin inhibitor, or a factor Xa inhibitor). […] Long-term oral anticoagulation to prevent stroke is required for patients with chronic or recurrent atrial flutter. […] Recurrent episodes are prevented with class Ia, Ic, or III antiarrhythmic medications along with AV nodal suppression or, more effectively, by cavotricuspid isthmus ablation.

• #12 Atrial flutter – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/atrial-flutter/diagnosis-treatment/drc-20572204

  Atrial flutter treatment depends on your overall health and how severe your symptoms are. Treatment may involve medicine or a heart procedure. […] If you have atrial flutter, your healthcare professional may give you medicines to: Control the speed of the heartbeat. Restore the heart rhythm. Prevent blood clots if you also have AFib. […] If medicine doesn’t control atrial flutter, a heart doctor may try to reset your heart rhythm using a procedure called cardioversion. […] Cardioversion can be done in two ways: Electrical cardioversion. Paddles or patches on the chest send electric shocks to the heart to reset its rhythm. This treatment is commonly used for people with unstable atrial flutter. After electrical cardioversion, you may need medicines to control your heart rhythm for the rest of your life.

• #12 Atrial flutter – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/atrial-flutter/diagnosis-treatment/drc-20572204

  Radiofrequency ablation is another treatment for atrial flutter. Your heart doctor may suggest this treatment if you have repeated bouts of atrial flutter. But it may be used at other times. The treatment uses thin, flexible tubes called catheters and heat energy to create tiny scars in the heart. Heart signals can’t pass through the scars. So the scars block the faulty electrical signals that cause the irregular heartbeat. […] Radiofrequency ablation has been shown to improve health-related quality of life for people with atrial flutter.

• #13 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=134&contentid=229

  The goal of treatment is to control the heart rate, prevent stroke, and maintain a normal heart rhythm. […] To control heart rate, you may be given a prescription medicine that can slow down the heart rate. […] To prevent stroke, your healthcare provider may prescribe a blood thinner (anticoagulant) to prevent a blood clot in the heart. A clot can form because blood can pool in the fluttering atria instead of being pumped out normally. This clot can break free and travel to the brain. […] Rhythm control involves either medicine or a procedure: […] Antiarrhythmics. These medicines can be taken as needed to stop an episode. Or you can take them every day to prevent future atrial flutter. […] Electrical cardioversion. This is an outpatient procedure where large electrode patches are placed on your chest and back. Energy is sent through these patches as a shock that is synchronized with your heartbeat. In many cases, this restores normal rhythm. This is typically done with IV sedation so that the shock is not felt. Sometimes your healthcare provider may start you on an antiarrhythmic medicine around the time of the cardioversion. This helps maintain a normal rhythm for a longer period of time after cardioversion. Or it may help the cardioversion to be a success.

• #14 Atrial flutter: RF, differential diagnosis, management strategies

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-6/Atrial-flutter-RF-differential-diagnosis-management-strategies-Title-Atria

  Atrial flutter seems to be an easy electrocardiographic (ECG) diagnosis, which can be done by a medical student. It is treated in daily practice mostly with DC cardioversion and subsequent antiarrhythmic drug use. […] Avoiding these triggering circumstances might help in preventing future attacks. Furthermore, certain patients are referred for radiofrequency ablation (which is an effective treatment of „classical” atrial flutter), when in fact their true diagnosis is left atrial focal tachycardia – where radiofrequency ablation is substantially more difficult and provides only questionable long-term benefit. […] DC-synchronized shock (50 J) is indicated in all urgent situations (e.g. hemodynamic compromise). The success rate is between 95-100%. Alternative non-pharmacologic treatment by atrial overdrive pacing (transvenous or transoesophageal) has a success rate of 82% and is especially used during the post-operative period in cardiac surgery. The recently published LADIP trial showed a 100% success rate of radiofrequency ablation as first line treatment.

• #14 Atrial flutter: RF, differential diagnosis, management strategies

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-6/Atrial-flutter-RF-differential-diagnosis-management-strategies-Title-Atria

  Intravenous betablockers or calcium channel blockers (dilitiazem or verapamil) slow the heart rate, but in few patients can it terminate the arrhythmia. Intravenous ibutilide converts atrial flutter to sinus rhythm in 38-76% and this occurs within cca 30 minutes. […] Oral dofetilide has 73% efficacy for the maintenance of sinus rhythm at 1 year, while oral flecainide has 50% long-term efficacy. […] Anticoagulation therapy is indicated for all patients with atrial flutter except those with contraindication and except patients with „lone” atrial flutter.

• #15 EM@3AM: Atrial Flutter – emDocs

  https://www.emdocs.net/em3am-atrial-flutter/

  Pharmacologic conversion with antiarrhythmics (procainamide, ibutilide, flecainide) for the stable low-risk patient. […] Anticoagulation: Clear guidelines remain controversial. […] Cardiovert without anticoagulation if there is a very clear history that onset of flutter was < 48h and patient with low risk of stroke. [...] If < 48h and patient at high risk of stroke (mechanical valve, rheumatic heart disease, history of TIA/stroke), proceed with rate control, and patient should receive OAC for 3 weeks before and 4 weeks following cardioversion. [...] Flutter also requires thromboembolic risk stratification for anticoagulation.

• #16 Atrial Flutter > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/atrial-flutter

  Treatment includes medication, medical procedures, pacemaker, surgery. […] A number of treatments are available for atrial flutter, including medications and medical procedures. These interventions help to lower stroke risk and improve symptoms. […] First-line treatments for atrial flutter aim to slow the heart rate (with amiodarone, digoxin, beta-blockers or calcium channel blockers) and to reduce the risk of clotting (with heparin, warfarin, or other anticoagulants). […] Procedures that help treat this condition include: Catheter ablation, in which heat, cold, or laser light is directed at the specific area within the heart that is causing atrial flutter, with the goal of destroying the tissue and blocking the electrical loop. […] Cardioversion, during which an external electrical shock is applied to the heart to change its rhythm, to return the upper chamber contractions to normal.

• #16 Atrial Flutter > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/atrial-flutter

  Pacemaker, a small device that is implanted near the heart, which may help the heart to maintain a regular, healthy pace if other, more definitive therapies are not possible. […] Surgery may also be an option for certain patients, depending on their circumstances and the severity of the condition. […] Ablation can be curative for the majority of patients with atrial flutter, and for those who can’t be treated with ablation, the condition that can be managed with medications and other procedures, if necessary.

• #17 Atrial Flutter Treatment Miami, Florida

  https://www.theafibclinic.com/other-arrhythmia/atrial-flutter/

  Atrial flutter requires treatment to: […] Restore rhythm to normal by electrical shock to the chest (cardioversion), medicines to restore and maintain rhythm, and more effective catheter ablation; […] Atrial flutter ablation is the only definitive treatment option for patients with flutter and it has very high cure rates (over 95%), with very low risks. […] Catheter ablation is considered the best option for patients with atrial flutter.

• #18 Atrial flutter ablation – Type – Mayo Clinic

  https://www.mayoclinic.org/tests-procedures/atrial-flutter-ablation/pyc-20385002

  Atrial flutter ablation is a treatment for a rapid, fluttering heartbeat. It uses heat energy to create tiny scars in an upper chamber of the heart. Heart signals can’t pass through the scars. So the scars block the faulty electrical signals that cause the irregular heartbeat. […] Atrial flutter ablation is done to control the symptoms of atrial flutter. Atrial flutter ablation helps reset the heart’s rhythm, which may improve quality of life. […] Then heat energy, called radiofrequency energy, is used to create small scars in the upper chambers of the heart. The scarring blocks the electrical signals that cause atrial flutter. […] After atrial flutter ablation, you need regular health checkups. Most people see improvements in their quality of life after this type of cardiac ablation. But sometimes the irregular heartbeat comes back. If this happens, you may another ablation or other heart treatments.

• #19 Catheter Ablation for Atrial Fibrillation & Atrial Flutter | NYU Langone Health

  https://nyulangone.org/conditions/atrial-fibrillation-atrial-flutter/treatments/catheter-ablation-for-atrial-fibrillation-atrial-flutter

  Catheter ablation is an emerging technique that is used to treat atrial fibrillation and atrial flutter. […] By destroying the tissue causing the irregular heartbeat, ablation can restore and maintain normal heart rhythm without the use of medications. This minimally invasive procedure has revolutionized the treatment of arrhythmias by eliminating the need for surgery. […] Catheter ablation aims to silence the heart tissue that is sending the wrong messages, allowing the correct signals to be received and normal heart rhythm to resume. […] The muscles around the pulmonary veins, which carry oxygenated blood from the lungs to the heart, are often ablated, because this is a common source of arrhythmias. […] You may continue to feel the symptoms of arrhythmia for up to six weeks after the ablation, until the heart muscle fully heals. This is normal.

• #20 Atrial flutter: your comprehensive guide | Top Doctors

  https://www.topdoctors.co.uk/medical-articles/your-guide-to-atrial-flutter

  Atrial flutter is initially treated with drug therapy. Drugs that your doctor will consider include anticoagulation, commonly known as blood thinners, such as warfarin or a newer class of drugs termed direct oral anticoagulants such as apixaban, rivaroxaban, dabigatran or edoxaban. In addition, if your heart rates are consistently elevated, your doctor may suggest a rate-limiting drug such as a beta-blocker (bisoprolol, metoprolol) or calcium blocker (verapamil, diltiazem). […] While its initially treated with drug therapy, which may help minimise the risk of stroke and slow down the heart rate, this wont cure atrial flutter. Its ultimately cured by a catheter ablation strategy which has a very high success rate; around 95% of patients have no recurrence of atrial flutter after catheter ablation. In this procedure, catheters (flexible electrical tubes) are inserted through the groin via the femoral vein into the heart. Once it’s in the right atrial chamber, radiofrequency energy is delivered to cauterize (burn) areas of the heart which are responsible for perpetuating this circuit that causes atrial flutter. The procedure takes anywhere from 45 to 90 minutes typically and can be done under local anaesthesia or general anaesthesia.

• #20 Atrial flutter: your comprehensive guide | Top Doctors

  https://www.topdoctors.co.uk/medical-articles/your-guide-to-atrial-flutter

  Cardiac ablation for atrial flutter should be offered to most patients. However, in some cases, its difficult to offer a patient the procedure because: The patient is very frail; They cannot lie down for an hour on the catheter lab table due to back problems; The catheter lab cannot accommodate patients due to morbid obesity (weight 150kg). […] Atrial flutter ablation carries a success rate of around 95% with a minor complication rate (3%) of groin haematoma (bruising), and a very rare complication rate (less than 0.5%) of stroke, heart attack or cardiac perforation that would need emergency bypass surgery. […] A cardiologist with a specialist skillset in ablation (electrophysiologist) performs ablation. These procedures are mainly carried out in larger specialised consultative cardiology units with the relevant expertise and support for electrical procedures.

• #21 Atrial Flutter — Diagnosis, Management and Treatment | IntechOpen

  https://www.intechopen.com/chapters/48430

  Atrial flutter has been traditionally defined as a supraventricular arrhythmia with an atrial rate of 240-360 beats per minute (bpm). […] Due to recent innovations in technology, catheter ablation has emerged as the most viable option with a success rate of more than 90 %. […] Rate control is generally reserved for patients who are in permanent atrial flutter and have no or minimal symptoms and cannot achieve rhythm control due to co-morbidities or are not willing to undergo procedures or take medications. […] In an acute setting, atrial flutter with hemodynamic compromise or rarely significant cardiac symptoms (i.e. severe chest pain), synchronised direct current cardioversion is indicated to revert patients to sinus rhythm. […] Ablation therapy for typical atrial flutter targets the cavo-tricuspid isthmus (CTI).

• #21 Atrial Flutter — Diagnosis, Management and Treatment | IntechOpen

  https://www.intechopen.com/chapters/48430

  In the management of especially typical atrial flutter, ablation has evolved as the first-line treatment, even after a single episode of documented symptomatic atrial flutter above antiarrhythmic pharmacotherapy. […] Ablation for atrial flutter using the Maximum Voltage Guided technique results in significantly less ablation applications than the traditional approach, potentially by concentrating ablation lesions on the muscle bundles responsible for Trans-isthmus conduction. […] Cryoablation is another ablation modality which also has a good success rate with a 10 % recurrence rate. […] Atrial flutter is a common atrial arrhythmia with a characteristic mechanism. Its morbidity and mortality are similar to atrial fibrillation; but unlike atrial fibrillation, it can be cured.

• #22 Atrial Flutter – Heart Rhythm CentreHeart Rhythm Centre

  https://heartrhythm.com.au/symptom/atrial-flutter/

  Atrial flutter can last for a few minutes or may continue indefinitely (or until stopped with treatment). […] The two main types of treatment are medication and catheter ablation. […] Medications do not cure atrial flutter. […] Catheter ablation is a technique for curing atrial flutter. The aim of catheter ablation is to destroy the short circuit which causes atrial flutter. […] The success rate for the common or typical type of atrial flutter is very high (typically 95-98%. […] The risks of the procedure are generally small. […] Many people feel well enough to return to work 2-3 days after the procedure. […] It is recommended patients remain in bed for approximately four hours after catheter ablation.

• #23 Atrial Flutter Ablation | Heart Rhythm Clinic

  https://www.heartrhythmclinic.com.au/ablation-therapy/afl-ablation/

  Catheter ablation for atrial flutter involves ablating a critical region of tissue in the right atrium which supports the atrial flutter circuit. This breaks the circuit and prevents atrial flutter from recurring. […] The success rate of the procedure is 95 to 98%. The risk of the atrial flutter returning or recurring after an apparently successful procedure is approximately 2%. […] Overall, catheter ablation is a safe and highly effective way to cure patients suffering from atrial flutter.

• #24 Atrial Flutter Ablation – Melbourne Heart Rhythm

  https://www.melbourneheartrhythm.com.au/learn/procedures/12-atrial-flutter-ablation?showall=1

  Radiofrequency ablation. This procedure carries a success rate of approximately 95% for curing the atrial flutter. The risk of the flutter returning at some time in the future is approximately 10%. […] Radio-frequency ablation is an effective and safe way to cure patients suffering from atrial flutter.

• #25 Ablation to Treat Atrial Flutter

  https://my.clevelandclinic.org/health/treatments/24535-atrial-flutter-ablation

  Atrial flutter ablation has a complication rate of less than 1%. Rare complications of atrial flutter ablation include: Heart block, Stroke, Cardiac perforation (putting a hole in your heart by mistake), Infection, Bleeding. […] You should be able to get back to your normal activities the day after you go home. Wait three days before doing physically demanding activities. […] Atrial flutter ablation success rates are high. Talk with your provider to find out if this treatment is a good option for you.

• #26 Atrial Flutter (AFL): Abnormal Heart Rhythm | Doctor

  https://patient.info/doctor/atrial-flutter

  All patients should be assessed for their risk of stroke and the need for thromboprophylaxis; the choice of anticoagulant is based on the same criteria as for atrial fibrillation. […] After successful catheter ablation, if sinus rhythm is still present, NICE guidance suggests anticoagulation should be continued indefinitely. […] Patients with atrial flutter should be given antithrombotic therapy in the same manner as those with atrial fibrillation. […] Long-term anticoagulation is therefore advised for patients with persistent or paroxysmal atrial flutter where stroke risk is considered significant when balanced against bleeding risk as per the details in the Atrial Fibrillation article. […] Cardioversion of atrial flutter presents similar risks to cardioversion of atrial fibrillation and therefore requires similar anticoagulation.

• #26 Atrial Flutter (AFL): Abnormal Heart Rhythm | Doctor

  https://patient.info/doctor/atrial-flutter

  Atrial flutter is one of the more common atrial arrhythmias (supraventricular arrhythmias). […] Like atrial fibrillation, treatment options for atrial flutter involve either controlling the ventricular rate or attempting to restore and maintain sinus rhythm. However, atrial flutter generally responds less well to drug treatment than atrial fibrillation. […] Conversion to sinus rhythm can be achieved by electrical cardioversion (by cardiac pacing or direct current), pharmacological cardioversion, or catheter ablation. […] Catheter ablation is suggested as the first-line therapy in patients with atrial flutter and normal or mildly enlarged left atrial size. The success rate of radiofrequency catheter ablation for atrial flutter is 90-95%. […] Direct current cardioversion is usually the treatment of choice when rapid conversion to sinus rhythm is necessary (eg, when atrial flutter is associated with haemodynamic compromise).

• #27

  https://step2.medbullets.com/cardiovascular/120017/atrial-flutter

  Treatment for atrial flutter is the same as atrial fibrillation except that catheter ablation is a definitive therapy for atrial flutter. […] Rate control is indicated for all patients and can be achieved with calcium channel blockers, beta-blockers, and digoxin. […] Rhythm control is indicated for patients who are contraindicated to catheter ablation therapy. […] Anticoagulation is indicated once rate has been controlled for patients who meet the criteria according to the CHA2DS2-VASc score, with options including aspirin, warfarin, dabigatran, rivaroxaban, and apixaban. […] Synchronized cardioversion is indicated for unstable patients. […] Catheter ablation is the definitive treatment and often has superior long-term outcomes compared to therapies targeting rate-control or rhythm-control.

• #28 Management of atrial fibrillation-flutter: uptodate guideline paper on the current evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6197036/

  The term flutter and fibrillation were first coined to differentiate the differences between fast, regular contractions in Atrial Flutter (AFLUT) with irregular, vermiform contractions of Atrial Fibrillation (AFIB). Management of these two diseases has been a challenge for physicians. Rate control (along with rhythm control) is the first line of management for symptomatic AFIB/AFLUT with Rapid Ventricular Rate (RVR). […] Anti-coagulation therapy in both the disease population is essential. Catheter ablation is an effective treatment option in certain patients that have AFIB/AFLUT refractory to medical management. […] Newer techniques like left atrial appendage (LAA) has been developed and is a highly attractive concept for the future in the management of AFIB/AFLUT. […] Rate control is the first line of management for symptomatic AFIB/AFLUT with Rapid Ventricular Rate (RVR). For the majority of patients that are hemodynamically stable and do not require immediate cardioversion, anti-arrhythmic drug therapies can potentially be utilized.

• #28 Management of atrial fibrillation-flutter: uptodate guideline paper on the current evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6197036/

  However, in some situations, AFLUT may not be well controlled by these anti-arrhythmic drugs (digoxin, beta-blockers and calcium channel blockers), making cardioversion to sinus rhythm necessary. […] Rhythm control could be achieved with medications or via synchronized cardioversion in both AFIB and AFLUT. […] Another important step is to anti-coagulate the patient before, during and after cardioversion. […] Anti-coagulation therapy in is essential in both these diseases since these patients are more susceptible to forming blood clots in the atria which can be dislodged into the systemic circulation causing a stroke. […] Catheter ablation for the treatment of AFIB/AFLUT is increasingly being used as an alternative to medical management, or when medical management has been ineffective or not tolerated.

• #28 Management of atrial fibrillation-flutter: uptodate guideline paper on the current evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6197036/

  While ablation does not eliminate the AFIB/AFLUT per se, it can limit the ventricular rate by eliminating triggers and altering electrophysiological connections in the heart in a similar fashion to rate control anti-arrhythmic drugs. […] An alternative approach to prevention of cardiac embolism in patients with AFIB/AFLUT is therefore desirable. One that can be used in all patients and does not require anticoagulation other than low-dose aspirin. […] It is on this basis that the left atrial appendage (LAA) has been developed and is a highly attractive concept for the future in the novel management of AFIB/AFLUT. […] For years, the first line treatment for AFIB/AFLUT has been rate control (along with rhythm control). However, with the advent of technology and many new drugs/devices under clinical investigation, this might change in the future.

• #29 Atrial Flutter ECG, Causes, Symptoms, Treatment, Medication

  https://www.medicinenet.com/atrial_flutter/article.htm

  Anticoagulants […] These are used to prevent thromboembolic complications (blood clots). […] Examples include: warfarin (Coumadin, Jantoven), heparin, dabigatran (Pradaxa), apixaban (Eliquis), rivaroxaban (Xarelto). […] The choice of medication(s) to use is based on your medical condition. These medications should be discussed with your doctor or other healthcare professional before you take them. […] What is the prognosis and life expectancy for atrial flutter? […] The prognosis and life expectancy for a person with atrial flutter depend on the patient’s underlying condition. […] Those with complicated medical conditions and who respond poorly to drugs or procedures have a reduced prognosis. […] However, patients who undergo successful ablation have an excellent prognosis. […] Although there is little or no data available on life expectancy with atrial flutter, data from the well-known Framingham heart study suggests that patients with atrial fibrillation, which is closely related to atrial flutter, have a shorter lifespan than normal control individuals although how much shorter is not clear.

• #30 Revisiting an Underrecognized Strategy for Rhythm Management: Hybrid Therapy for Patients who Convert from Atrial Fibrillation to Flutter on Antiarrhythmic Drugs

  https://www.innovationsincrm.com/cardiac-rhythm-management/articles-2019/october/1479-revisiting-an-underrecognized-strategy-for-rhythm-management

  Atrial fibrillation (AF) is often treated with antiarrhythmic drugs (AADs) or catheter ablation. […] In a unique subset of patients, AF can convert to atrial flutter (AFL) after the initiation of an AAD. […] It has previously been shown that, in this subset of patients, cavotricuspid isthmus (CTI) ablation followed by the continuation of the AAD regimen has an unusually high rate of successfully maintaining sinus rhythm. […] This strategy, however, is underrecognized in current clinical practice, and no large prospective trials of this method of treatment exist at this time. […] We suggest that consideration of this approach for treating AF, particularly in patients with new-onset or paroxysmal AF, should be given as long as there are no contraindications to using a class Ic antiarrhythmic in a particular case.

• #30 Revisiting an Underrecognized Strategy for Rhythm Management: Hybrid Therapy for Patients who Convert from Atrial Fibrillation to Flutter on Antiarrhythmic Drugs

  https://www.innovationsincrm.com/cardiac-rhythm-management/articles-2019/october/1479-revisiting-an-underrecognized-strategy-for-rhythm-management

  A hybrid approach to the treatment of AF has been suggested that involves CTI ablation and the maintenance of the antiarrhythmic medication for patients who initially convert from AF to typical AFL. […] This strategy has been shown to have a high success rate in limited studies. […] We suggest that conversion from AF to AFL with class IC antiarrhythmics selects for a subset of the population in whom these medications are highly effective.

• #31 Atrial fibrillation and atrial flutter: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000184.htm

  Cardioversion treatment may be used to get the heart back into a normal rhythm right away. There are two options for treatment: […] Daily medicines taken by mouth are used to: […] A procedure called radiofrequency ablation can be used to scar areas in your heart where the heart rhythm problems are triggered. […] People with AFib will most often need to take blood thinner medicines. […] Another stroke prevention option for people who cannot safely take these medicines is the Watchman Device, which has recently been approved by the FDA. […] Your provider will consider your age and other medical problems when deciding which stroke prevention methods are best for you.

• #32 Atrial Flutter

  https://www.rwjbh.org/treatment-care/heart-and-vascular-care/diseases-conditions/atrial-flutter/

  The atrial flutter treatment that is most appropriate for you will depend on how long you’ve had atrial flutter, how bothersome your symptoms are and the underlying cause of your atrial flutter. Treatment options include: […] Lifestyle Changes […] Avoid smoking. […] Eat a heart-healthy diet. […] Exercise under the directions of your doctor. […] If you’re overweight, talk to your doctor about weight loss options. […] Manage stress. […] Limit alcohol consumption and caffeine consumption. […] Make and keep appointments to see your doctor for routine checkups and follow-up tests. […] Medications […] Anticoagulants blood-thinners will help treat, prevent, and reduce blood clotting. […] Beta blockers will help reduce your blood pressure. […] Calcium channel blockers will help relax blood vessels and increase the supply of blood and oxygen to the heart while also reducing the heart’s workload. […] Medical and Surgical Procedures […] Cardioversion […] Cardiac ablation to treat arrhythmias […] Pacemaker implantation […] Implantable cardioverter defibrillator (ICD)

• #33 Catheter Ablation a First-Line Treatment for Atrial Flutter | UC San Francisco

  https://www.ucsf.edu/news/2014/07/115611/catheter-ablation-first-line-treatment-atrial-flutter

  Performing a multivariate analysis adjusting for patient demographics and comorbidities, the UCSF researchers determined AFL catheter ablation reduced the risk for overall hospital-based health care by 6 percent, inpatient hospitalization by 12 percent and emergency department visits by 40 percent. […] However, we believe our study findings, in combination with the previous literature and our clinical experience, are sufficient to support catheter ablation as first-line treatment for AFL, Marcus said.

• #34 Treating Atrial Flutter Symptoms | University of Utah Health | University of Utah Health

  https://healthcare.utah.edu/cardiovascular/conditions/atrial-flutter

  Cardiac ablation is very effective for people with typical atrial flutter, providing a cure for 90 percent of these patients. […] Other treatment options for atrial flutter include medication to control your heart rhythm. Medication alone is successful in 20 to 30 percent of people with atrial flutter. […] Electrical cardioversion therapy, which involves using a special machine to send electrical energy to the heart muscle. This commonly will restore your normal heart rhythm. But over time, atrial flutter often returns since cardioversion alone does not correct the underlying causes of an abnormal heart rhythm. […] Most people with atrial flutter experience an improvement in symptoms after treatment. However, some symptoms may continue, even after treatment. If that happens, our cardiologists will continue to work with you to minimize your symptoms and help you experience the best quality of life possible.

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