Atrial Flutter

Diagnosis

A comprehensive evaluation at Mayo Clinic helps to diagnose atrial flutter and determine the best options for treatment. Most people with atrial flutter require treatment, whether or not they have symptoms, because their risk of stroke is higher than usual.

Active Tests

These tests involve trying to induce an irregular heartbeat while the patient is monitored closely. They include:

Electrophysiology (EP) testing and mapping
Catheters (thin, flexible tubes) with electrodes at the tips, are threaded through the patient's blood vessels to various locations within the heart. Once in place, the electrodes can precisely map the spread of electrical impulses through the heart.

During the test, the electrophysiologist (a cardiologist who specializes in heart rhythms) may use the electrodes to stimulate the heart to beat at rates that may trigger — or halt — an irregular heartbeat. This allows the doctor to observe the location of the arrhythmia and the mechanics of the heart that may be causing the irregular heartbeat.

The ability to trigger and then stop an atrial fibrillation may also be used to test the effectiveness of various treatment methods. For example, if catheter radiofrequency ablation (atrial fibrillation ablation) — a catheter-based treatment option for many arrhythmias — is determined by the doctor to be appropriate treatment, the procedure can be performed during EP testing. Read more about atrial fibrillation ablation.

Stress test
Atrial fibrillation may be triggered or worsen when the patient is exercising. During a stress test, the patient may exercise on a treadmill or stationary bicycle, while an ECG closely monitors heart activity. The test may involve a drug to stimulate the heart similar to stimulation by exercise. This may help patients who have difficulty doing exercise. The stress test can also be used to detect coronary artery disease.

Passive Tests

These tests involve monitoring the heart during regular activity. They include:

Electrocardiogram (ECG)
Electrodes (sensor patches with wires attached) are placed on the patient's skin to measure the electrical impulses given off by the heart. The ECG measures the timing and duration of each electrical phase in the heartbeat.

Holter monitor
A Holter monitor is a portable ECG device that the patient wears for a day or more to record the heart's electrical activity during the daily routine.

Echocardiogram (Doppler echocardiogram)
This test uses sound waves to produce detailed images of the patient's heart. Through a handheld device (transducer) on the patient's chest, sound waves bounce off the heart and are reflected to produce video images of the heart's size, structure and motion. The echocardiogram can also be used to measure the heart's blood volume and the speed and direction of blood flow through the heart.

Blood tests
These may help rule out thyroid problems or other blood chemistry abnormalities that may lead to atrial fibrillation.