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Atrial flutter is an abnormal heart rhythm, or arrhythmia. This starts in the upper chambers of your heart (right and/or left atrium). When you have atrial flutter, the heart is not working as well as it should. This abnormal electrical signal can cause your heart to beat in a fast and consistent pattern.
When the heart beats too fast, the heart chambers cannot fill with blood fast enough or empty blood into the bottom chambers. Atrial flutter can cause symptoms that can be treated with medicine and/or ablation.
Types of Atrial Flutter
There are different types of atrial flutter. Your providermay be able to tell you the type based on your EKG (if captured).
Typical (most common): Abnormal electrical signals follow a counterclockwise pattern in your top right chamber.
Reverse typical: Abnormal electrical signals move in a clockwise direction in your top right chamber.
Atypical (not common unless you’ve had surgery or ablations before): Abnormal electrical signals can happen in the left and/or right top chamber.
Ablation
An ablation is a procedure used to try to treat an abnormal heart rhythm. An ablation can stop, block, or disrupt the electrical signal. This will reduce the the chance the rhythm happens again.The procedure length depends on the type of irregular rhythm being treated and where it is located.
How Ablation Works
During the procedure, one or more thin, flexible tubes (called catheters) will be inserted into a blood vessel and then are placed in the heart. Sensors on the catheter record the heart’s electrical activity. This can help locate the area of the flutter. You may be exposed to some Xray (fluoroscopy) during the procedure.
With the catheter, a 3D picture or map of your heart is created. This shows areas of normal and abnormal tissue in the heart. Once the correct area is found, ablation will be used to treat the flutter.
Types of Ablation
Ablation uses heat and/or cold energy to create tiny scars in the heart to block the irregular rhythm. The types of ablation are :
Radiofrequency: Heat/burning is used for the ablation.
Cryotherapy: Cooling/freezing is used for the ablation.
For certain patients, freezing therapy may be safer than heat In some cases, both ablation types may need to be used during your procedure.
After Your Procedure
You will rest in the recovery area for a few hours. Depending on your recovery, you may go home or stay at the hospital.
After your procedure, you may have:
Soreness or tenderness at the sites that may last 1 week.
Bruising at the site that may take 2-3 weeks to go away.
A small lump (dime to quarter size) at the site which may last up to 6 weeks.
Pain Control
You may take a mild pain reliever such as acetaminophen (Tylenol®). Ask your care team if you can use ibuprofen (Motrin®) or other NSAID medicines as these can increase your risk of bleeding (especially if you are on a blood thinner).
You may place an ice pack or warm pack over the site for 20 minutes every 2 hours. If the sites are wet from the pack, remove it, and gently wipe the area.
Care of the Puncture Site(s)
It is important that you take care of your sites to prevent an infection. Keep the sites clean and dry for 24 hours.
You may remove the dressing(s) and shower after 24 hours. Remove the dressingover the site before taking a shower. To care for the puncture site:
Gently clean the site for 3 days with soap and water. Pat dry and leave open to air.
Keep the site dry.
Inspect the site daily for redness, swelling, or drainage.
You may feel a small lump (dime to quarter size) under the skin. Most of the time, this goes away within 6 weeks. In some cases, it can persist if scar tissue forms.
Please let your team know if you have any new or increasing pain at the site.
Activity
Avoid strenuous activity. Do not lift anything over 10 pounds for 7 days.
Do not soak in a bathtub, hot tub or go into a swimming pool, lake, or river until the site is completely healed.
After 7 days, you may resume normal activity.
Do not drive for 24 hours, unless told otherwise.
Do not make any important decisions until the next day.
Going Home
You may go home the same day or stay in the hospital overnight. We will review discharge instructions with you.
If you go home the same day, someone should drive you home and stay with you overnight.
Heart Healthy Diet
Include heart healthy foods in your diet, such as: vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit sodium, alcohol, and sugar.
Lifestyle Changes
Do not smoke.
Be active. Try for at least 30 minutes of activity on most days of the week. Talk to your provider about what type and level of exercise is safe for you.
Maintain a healthy weight. Lose weight if you need to.
Manage health problems such as high blood pressure, sleep apnea, high cholesterol, and diabetes.
Medicines
You will receive instructions about your medicines.. If you take or are prescribed a blood thinner, take this and do not skip any doses. Many patients will keep taking a blood thinner after the procedure.If you take Coumadin (warfarin), you will need to have a PT/INR level checked. You may need the dose adjusted. This will be done within 3-5 days of discharge.
Follow Up Visits
This will be arranged after your procedure. After the ablation, you may be asked to wear a heart monitor to look at your heart rhythm.
Return To Work
Talk to your clinician about when it is safe to return to work.
When to Get Emergency Help
Call 911 or go to the nearest emergency room if you have:
Trouble swallowing, or you are coughing up or vomiting blood.
Severe swelling.
New numbness, weakness or coldness in your extremities (arms, hands, fingers, legs, feet, toes).
Skin turning blue.
Sudden bleeding or swelling at the puncture site(s). If this occurs, apply direct pressure. If the bleeding does not stop after 10 minutes of placing constant pressure on the site, call 911. Keep pressure on the site until help arrives.
Signs of stroke:
Sudden face drooping, arm or leg numbness weakness, confusion.
Trouble seeing, trouble speaking, trouble walking, or severe headache.
When to Call
Call if you have:
Chest pain or new back pain
Increased shortness of breath
Signs of infection around the puncture site, such as:
Redness
Warmth
Swelling
Drainage
A fever over 101.5°F
Trouble urinating
A sudden increase in weight overnight (more than 3 pounds), or over a few days, as this could be a sign of fluid retention
Been prescribed a blood thinner and have questions or concerns about stopping this.
Who To Call
UW Health Heart and Vascular Clinic
Monday-Friday, 8:00 am to 4:30 pm
608-915-0200
The toll-free number is 1-800-323-8942.
After hours, nights, weekends, and holidays this number will give you the paging operator. Ask for the Cardiology Fellow on call. Give your full name and phone number with the area code. A clinician will call you back.