Atrial Flutter Ablation

General Information

How Do Abnormal Heart Rhythms Occur?

In some hearts, an abnormal heart rhythm develops when an electrical impulse starts from a different location, other than the SA node, or follows a route (or pathway) that is not normally present. This is what happens in atrial flutter. A short-circuit develops in the right atrium.

Atrial Flutter

A single abnormal electrical short-circuit originates from the right atrium.

Atrial flutter is due to a short circuit in one of the upper chambers of your heart termed the right atrium. This rapid short circuit has several consequences:

The short circuit drives the pumping chambers very rapidly and sometimes erratically. This produces palpitations, shortness of breath and tiredness. In some people it can also cause dizziness and chest pain.

The short circuit results in ineffective pumping of the upper chambers. This leads to slow blood flow in both of these upper chambers (the left and right atrium). This can rarely cause blood clots and possibly stroke. One of the major reasons to cure atrial flutter is to prevent this risk of stroke.

 What Treatments Are Available For Atrial Flutter?

Atrial flutter can be treated with medication. In some people these medications can be very effective. In others however, the medications are ineffective and may produce side effects. If you elect to take medication, your doctor will discuss the different options and the possible side effects of these medications.

DC Shock. When the heart is in flutter it can be reverted to the normal rhythm with a "shock on the chest". You receive a short general anaesthetic and the shock reverts the rhythm to normal in almost all cases. With this approach the possibility of the flutter returning remains present (approximately 50% of patients will have another episode of atrial flutter over the next year). In addition, most patients will also require medicine to try to prevent the flutter coming back.

Blood Thinning medication. Because of the risk that atrial flutter may return with the above treatments, most patients with atrial flutter will require blood-thinning medication to prevent blood clots forming. At your doctors' discretion this may either be aspirin or warfarin.

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 5%.

What Is Radiofrequency Ablation (RFA)?

Radiofrequency is a low power, high frequency energy that causes a tiny region of the heart, near the tip of the catheter to increase in temperature, thus ablating (or cauterising) a small area of abnormal tissue. Radiofrequency energy has been used for decades by surgeons to cut tissue or to stop bleeding. For the treatment of palpitations, a much lower power of radio-frequency energy is used.

  • Professor Sanders says...

    Atrial fibrillation is a consequence of several reversible risk factors - high blood pressure, diabetes, obesity, sleep apnoea, and excessive alcohol. Your management of atrial fibrillation must include strict control of these risk factors.

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