Atrial Flutter

Atrial flutter (AFL) is a condition related to atrial fibrillation, but it's an entirely separate rhythm with its own specialized therapies. AFL occurs when the upper chambers (atria) of the heart flutter at a regular and rapid rate, usually around 250-300 beats per minute. Heart rate in atrial flutter is typically at a steady rate of 150 bpm, as not every “flutter” conducts down the heart’s electrical tree. This is usually a hereditary and not an acquired heart problem. The rapid rate of the top chambers (atrium), as with atrial fibrillation, can cause blood clots in the heart, which is the No. 1 cause of stroke. Also, if left uncontrolled the rapid pulse can eventually cause damage to the pumping muscle of the heart.

Normally, electrical signals spread from the top of the heart to the bottom. The electrical signals begin in a group of cells called the sinus node or sinoatrial (SA) node, located in the right atrium. The signals travel from the SA node through the right and left atria, which causes blood to pump through the ventricles. The signals then move to a group of cells called the atrioventricular (AV) node, located between the atria and ventricles. This signal leaves the AV node and travels to the ventricles, causing them to pump blood to the lungs and rest of the body.

During AFL, abnormal electrical signals arise from the right atrium. The signals travel in a circular motion, causing the atria to beat faster than normal, resulting in an abnormal atrial flutter heart rate. This type of rhythm is called supraventricular tachycardia.

Risk Factors

  • Previous heart attack
  • High blood pressure
  • Diabetes
  • Chronic lung disease
  • Alcoholism


Like atrial fibrillation, AFL can sometimes cause no symptoms at all. However, some people have symptoms that are organized and predictable. These include:

  • Heart palpitations
  • Fast pulse
  • Chest pain
  • Lightheadedness and fainting


Treatment for atrial flutter is similar to atrial fibrillation. Physicians typically prescribe blood thinning medications for stroke prevention, as well as drugs to slow the heart rate during the flutter or prevent the arrhythmia altogether. These therapies are only suppressive.

At the Ben and Zelda Cohen Heart Rhythm Center, we focus on catheter ablation, a a curative therapy that renders medications unnecessary. The procedure is a same-day surgery with limited recovery time. Call 410-601-WELL (9355) to schedule an appointment.

Learn More

In this video, heart rhythm specialist Dr. Jeffery Banker discusses symptoms and treatment for atrial flutter.