Atrial Flutter: Symptoms & Signs

Medically Reviewed on 9/10/2019

Atrial flutter is a type of abnormal heartbeat or arrhythmia. It is characterized by a fast heart rate and a reduction in cardiac output that leads to characteristic symptoms. Palpitations, fatigue, shortness of breath, and poor exercise tolerance are the most common symptoms. Other less common symptoms can include lightheadedness, dizziness, fainting, or chest pain. Blood clots may form in the heart (thrombi) that may break off and travel to other parts of the body (emboli), leading to complications. The reduction in cardiac output (decreased volume of blood pumped by the heart), when untreated, can have serious consequences, including congestive heart failure, stroke, and heart attack.

Causes of atrial flutter

Atrial flutter is caused by an abnormality in the electrical pacemaker in the heart atrium that causes an irregular heartbeat. The exact reason this occurs is poorly understood, but there are certain conditions that increase the risk of developing atrial flutter. Some of these risk factors include high blood pressure, obesity, heart failure, coronary artery disease (coronary heart disease), atherosclerosis, aging, recent surgery, hyperthyroidism, diabetes, alcohol abuse and binge drinking, chronic lung disease (such as COPD and emphysema), and other serious illnesses. Heart diseases that damage the heart muscle (cardiomyopathy) and abnormal enlargement of the heart (hypertrophy) can also increase the risk of atrial flutter.

Alcohol (wine, beer, or hard liquor) as well as stimulant drugs like cocaine, amphetamines, diet pills, or cold medicines can lead to atrial flutter in susceptible people. Even caffeine may increase the risk.

Other atrial flutter symptoms and signs


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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.