Atrial Flutter

Diagnosis

A comprehensive evaluation at Mayo Clinic helps determine the severity of atrial flutter and the most appropriate treatment options. At Mayo Clinic, electrophysiologists (cardiologists with expertise in the diagnosis and treatment of heart rhythm disorders) lead a team of medical specialists in conducting tests to diagnose arrhythmia. Most people with atrial flutter require treatment, whether or not they have symptoms, because their risk of stroke is higher than usual and because their heart rate is too slow or too fast.

To diagnose atrial flutter, the physician may ask the patient about conditions that may trigger atrial flutter, such as heart disease or a problem with the thyroid gland. Or, the physician may test for those conditions. Several tests can help the physician better understand the cause of atrial flutter.

Some tests are performed at the clinic:

Stress test
Atrial flutter may be triggered or worsen when the patient is exercising. During a stress test, the person exercises on a treadmill or stationary bicycle with close monitoring of heart activity by an electrocardiograph (ECG). If patients have difficulty exercising, a drug may be given to stimulate the heart into mimicking its activity during exercise. The stress test can also be used to detect coronary artery disease.

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.

Echocardiogram (Doppler echocardiogram)
Sound waves 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 on a video monitor as 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 flutter or atrial fibrillation.

In addition, the heart may be monitored during regular activity.

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.

Event recorder
For irregular heartbeats that occur sporadically, this portable ECG device is kept at home so the patient can attach it and activate the ECG recording when experiencing arrhythmia symptoms. The device is small, about the size of a portable compact disc player, and can be clipped on to clothing and the electrodes (sticky pads with wires) applied by the patient on his or her chest. When the patient feels symptoms, a push of a button begins the ECG recording. For select patients, an implanted recorder may be used.