Atrial flutter natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Atrial flutter by nature occurs and then subsides. There are several complications that can occur, including hypotension, heart failure, angina, stroke, ventricular fibrillation, and sudden cardiac death. Prognosis varies from person to person and depends on the underlying cause and the presence of other risk factors.

Atrial flutter is by nature unstable. It usually reverts back to either sinus rhythm or atrial fibrillation. Chronic atrial flutter state is very rare.^[1][2]

• Common complications of atrial flutter include:^[3]
  • Myocardial ischemia
  • Dizziness or syncope
  • Heart failure (with either preserved or reduced left ventricular systolic function)
  • Stroke
  • Systemic embolism
  • Ventricular fibrillation
  • Sudden cardiac death

The prognosis of the patient depends on the underlying cause of flutter. After treating the acute episode of atrial flutter, sinus rhythm is usually restored and chronic therapy is not usually required. It is more difficult to control the heart rate in flutter compared to that in atrial fibrillation. It is very difficult to control the rate in a chronic flutter, as it is not responsive to antiarrhythmic agents. The risk for thromboembolism in atrial flutter is nearly similar to that of atrial fibrillation. The recurrence rate of flutter is very low in patients undergoing catheter ablation for type 1 flutter indicating a good prognosis.

Template:WH Template:WS CME Category::Cardiology