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Ask the doctor: Atrial fibrillation vs. atrial flutter

Q. What’s the difference between atrial flutter and atrial fibrillation?

A. Both of these heart-rhythm disorders arise from electrical misfires in the heart’s upper chambers, or atria. The symptoms are often similar—mainly palpitations and lightheadedness. The conditions can occur together, and both are treated with either drugs or procedures that restore the heart’s normal rhythm. But there are a few key differences.

Atrial flutter occurs when an extra or early beat initiates an abnormal electrical impulse that zips around the right atrium in a circular loop up to 300 times a minute. The atrioventricular (AV) node, which delivers the “pump now” signal to the heart’s lower chambers (ventricles), usually blocks about half of these signals. The ventricles then contract about 150 times a minute, or about twice as fast as normal. During atrial flutter, a person’s heartbeat tends to be rapid but regular.

In atrial fibrillation (or afib), the errant electrical impulses randomly trigger the AV node, leading to a fast and irregular heartbeat.

Both atrial flutter and afib can boost the risk of stroke if they persist for more than a couple of days. The main difference between the two is that atrial flutter often can be cured with radiofrequency ablation, a procedure that destroys the tiny area generating the abnormal electrical impulse. This procedure isn’t quite as successful in treating afib because it is more difficult to locate and destroy all the trouble spots triggering the problem.

— Deepak L. Bhatt, MD, MPH
Editor in Chief, Harvard Heart Letter

Posted by: Dr.Health

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