Atrial flutter

It is a heart rhythm disorder or arrhythmia, which manifests with normal or elevated heart rates. The upper chambers of the heart (atria) generate a very fast heartbeat that is transmitted to the lower chambers (ventricles) with a lower frequency. Depending on the cadence between atrial and ventricular beats, the pulse we detect in the patient will be faster or slower.

It usually occurs in patients with previous heart disease: valvular alterations, previous heart attacks, hypertension, previous heart surgery and other cardiopulmonary diseases such as Chronic Obstructive Pulmonary Disease (COPD).

Symptoms are directly related to the heart rate; it usually causes more symptoms the faster the pulse. The most frequent symptoms are palpitations, dizziness, anxiety, chest pain, shortness of breath and imminent sensation of death. 

Diagnosis is clinical, by interrogation and physical examination. It is confirmed by electrocardiogram; if the arrhythmia occurs intermittently, a continuous electrocardiogram recording (Holter) will be necessary.

Treatment is aimed at reverting the arrhythmia to sinus rhythm, which is the normal heart rhythm; if this is not possible, the tachycardia should be slowed until values below 100 beats per minute are maintained.