Atrial flutter

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A rapid atrial dysrhythmia, less disorganised than atrial fibrillation. See ECG findings

An oscillation maintained by conduction around a circuit around the valves occurs at around 160 beats per minute, with reduction in effectiveness of the ventricular filling and pump action of the heart. The abnormal rate is not so fast that each beat may not be transmitted via the AV node to the ventricles, leading to overwork of the ventricular muscle, or a 2:1 or 3:1 block may occur.

Interruption of the conducting loop by cardiac ablation is curative. Atrial fibrillation may follow in later years.

Flutter may be intermittent initially. Treatment with a beta-blocker eg Metoprolol and with Digoxin improves the situation.

Alcohol consumption encourages the development of flutter, to a small extent in chronic consumption (1.5 to 2 times in males), and with an acute toxic effect from increased consumption for instance on holiday.[1]


  1. Bandolier review of Framingham and other studies