Control the heart rate
Medication may be used to slow the ventricular response when clinically appropriate.
Medically reviewed by Dr. Kathy Shi, M.D., Ph.D. · SinoUnited Health
Atrial flutter care in Shanghai
Understanding atrial flutter and the rhythm behind it
Atrial flutter is a rapid rhythm that begins in the upper chambers of the heart. A clear assessment distinguishes it from atrial fibrillation and other tachycardias, evaluates symptoms and stroke risk, and identifies which treatment approach is appropriate for the individual patient.
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Understanding the condition
What is atrial flutter?
Atrial flutter is a type of supraventricular arrhythmia in which an electrical signal repeatedly travels around a pathway in the atria, the heart’s upper chambers. This organized circuit can make the atria beat very rapidly while the lower chambers respond at a slower rate.
Atrial flutter is different from atrial fibrillation. Flutter is usually driven by a more organized circuit, while atrial fibrillation involves disorganized electrical activity. The two conditions can occur in the same person, however, and may have similar symptoms and implications for blood-clot and stroke risk.
There are different forms of atrial flutter. Typical flutter commonly uses a pathway in the right atrium. Atypical flutter may follow a different pathway and can occur after heart surgery or a previous atrial ablation. The mechanism matters because it affects procedural planning and expected outcomes.
Symptoms and urgency
Some people feel a fast rhythm; others notice very little
The effect of atrial flutter depends on the heart rate, duration of the episode, heart function and other medical conditions. It can be continuous or intermittent.
Palpitations
A fast, pounding, fluttering or unusually steady heartbeat.
Reduced energy
Fatigue, weakness or reduced exercise tolerance.
Breathing or chest symptoms
Shortness of breath or chest discomfort.
Dizziness
Light-headedness, near-fainting or, less commonly, loss of consciousness.
Specialist assessment
Confirming the rhythm and seeing the complete picture
Symptoms alone cannot reliably distinguish atrial flutter from atrial fibrillation, atrial tachycardia or another rapid rhythm. An ECG or rhythm recording during an episode is therefore especially useful.
- 01Document the rhythm.
A 12-lead ECG, ambulatory monitor, wearable recording or implanted-device tracing may show the rhythm and ventricular response. - 02Assess the heart and contributing conditions.
The review may include an echocardiogram, blood tests, medication history and evaluation for relevant heart, lung or thyroid conditions. - 03Evaluate clot and stroke risk.
A clinician considers established risk factors and whether anticoagulation should be discussed. This decision must be individualized. - 04Define treatment goals.
Symptoms, rhythm duration, prior atrial fibrillation, earlier procedures and personal preferences all help shape the plan.
Individualized treatment
Rate, rhythm and stroke prevention are separate decisions
Treatment may address more than one goal. The appropriate combination depends on the documented rhythm and the patient’s wider clinical situation.
Restore normal rhythm
Cardioversion, antiarrhythmic medication or catheter ablation may be considered depending on the circumstances.
Address stroke risk
Anticoagulation decisions consider individual risk factors, rhythm duration and planned cardioversion or ablation.
Plan follow-up
Because atrial flutter and atrial fibrillation can coexist, follow-up may include additional rhythm monitoring and risk-factor care.
Rhythm-control treatment
When might atrial flutter ablation be discussed?
This information is general. Only a clinician who has reviewed the individual case can advise whether a procedure is appropriate.
The flutter mechanism
Typical right-atrial flutter and atypical flutter involve different circuits. ECG findings, earlier procedures and electrophysiology mapping help determine the strategy.
Symptoms and recurrence
Ablation may be discussed for recurrent or persistent flutter, significant symptoms, difficulty controlling the rate, or when a rhythm-control approach is preferred.
Related atrial fibrillation
Treating flutter does not guarantee that atrial fibrillation will not occur. The consultation should address both rhythms when relevant.
Benefits, risks and follow-up
A specialist should explain the expected goal, procedural risks, possibility of recurrence and whether anticoagulation or other treatment may still be needed.
Specialist experience
Arrhythmia assessment with Dr. Feifan Ouyang
Dr. Ouyang’s clinical work spans complex atrial and ventricular arrhythmias, electrophysiology mapping and catheter ablation. The first priority is to confirm the rhythm and understand the individual clinical context before recommending treatment.
View Dr. Ouyang’s experience220+Manuscripts and papers across cardiac electrophysiology and arrhythmia care
China · GermanyTraining, clinical practice and electrophysiology laboratory leadership
Atrial rhythmsClinical experience in complex atrial arrhythmia assessment and ablation
ShanghaiInvited arrhythmia specialist at Shanghai SinoUnited Hospital
Preparing for a consultation
Information that can make the first review more useful
The care team will explain how to share records securely. Do not send medical attachments through the initial website form.
Rhythm documentation
12-lead ECGs, monitor reports, smartwatch recordings reviewed by a clinician and the dates and duration of episodes.
Treatment history
Current and previous medicines, cardioversions, ablations and any relevant side effects.
Heart and risk assessment
Echocardiogram and other imaging reports, medical conditions, anticoagulation history and previous atrial-fibrillation records.
Frequently asked questions
Questions patients often ask about atrial flutter
These answers provide general education and do not replace an individual medical assessment.
Is atrial flutter the same as atrial fibrillation?
No. Atrial flutter usually involves an organized repeating circuit, while atrial fibrillation is more disorganized. They can occur in the same patient and share some treatment considerations.
Can atrial flutter increase stroke risk?
Yes. A clinician should assess individual blood-clot and stroke risk and advise whether anticoagulation is appropriate.
Can an ECG distinguish atrial flutter from other rhythms?
A 12-lead ECG often provides important clues, but interpretation can be more difficult with atypical flutter, prior procedures or certain heart rates. Additional monitoring or an electrophysiology study may sometimes be needed.
Can catheter ablation treat atrial flutter?
Catheter ablation is an established treatment for selected patients. The approach and expected outcome depend on whether the flutter is typical or atypical and on the person’s heart history.
Can atrial flutter return after ablation?
Recurrence is possible. Atrial fibrillation or another atrial arrhythmia may also occur, so follow-up remains important.
What records are most useful for a consultation?
An ECG recorded during the rhythm is especially useful, together with monitor reports, imaging, prior procedure reports and a complete medication list.
Request specialist care
Would you like an atrial flutter review?
Share basic contact information and the SinoUnited international care team can help coordinate the next appropriate step with Dr. Ouyang’s service.
Request a consultation For emergencies, contact local emergency services immediately.
Clinical references
Guidelines informing this page
- Page RL, et al. 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia. Heart Rhythm. 2016.
- Brugada J, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia. European Heart Journal. 2020.
- American Heart Association. What is Atrial Flutter? Last reviewed March 26, 2025.
Medically reviewed by: Dr. Kathy Shi, M.D., Ph.D.Affiliation: SinoUnited HealthReview date: July 21, 2026