What's the difference between atrial flutter and atrial fibrillation?

I have been diagnosed with atrial flutter, although I only have it occasionally. I have never heard of this and can only find information on atrial fibrillation. What’s the difference?

Senior Cardiac Nurse Christopher Allen says:

Atrial flutter and atrial fibrillation are both abnormal heart rhythms. They occur when there is an issue with the electrical signals and pathways in your heart, which usually help it beat in an organised, effective way.

Normally, the top chambers (atria) contract and push blood into the bottom chambers (ventricles). In atrial fibrillation, the atria beat irregularly. In atrial flutter, the atria beat regularly, but faster than usual and more often than the ventricles, so you may have four atrial beats to every one ventricular beat.

Atrial flutter is less common than atrial fibrillation

Atrial flutter is less common, but has similar symptoms (feeling faint, tiredness, palpitations, shortness of breath or dizziness). Some people have mild symptoms, others have none at all. About a third of people with atrial flutter also have atrial fibrillation.

Both conditions carry increased risk of stroke, usually managed by drugs (such as warfarin or a newer anticoagulant). This is why, whether you have atrial fibrillation or atrial flutter, it is vital to be diagnosed early so you can get the right treatment and reduce your stroke risk. Either condition may require medications to prevent your heart rate becoming too rapid.

Catheter ablation is usually considered the best treatment for atrial flutter, whereas medication is often the first treatment for atrial fibrillation. Catheter ablation is a procedure that is done under local anaesthetic, where radiofrequency energy is used to destroy the area inside your heart that’s causing the abnormal heart rhythm.

Christopher AllenMeet the expert

Christopher Allen helps manage the BHF’s genetic information service and has extensive specialist experience of working in coronary care.

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