What Is The Difference Between Atrial Fribrillation And Atrial Flutter And Why Do I Have Both Of Them?

Question: My doctor told me I sometimes have atrial fibrillation and at other times have atrial flutter. What is the difference between these two heart rhythm problems and why do I have both of them?

Answer :So atrial fibrillation atrial flutter are similar arrhythmia in that they both occur in the upper chamber and both cause the upper chamber to beat very rapidly. And they also both can cause symptoms and increase the risk of stroke. So in both cases you'll want to think about blood thinners. But there are very important differences between atrial fibrillation and atrial flutter -- both in terms of the precise mechanism of the arrhythmia, but also how they're treated.

Atrial flutter is an organized regular rapid upper chamber rhythm that goes in almost all patients at about 300 beats a minute -- typically between 250 and 350 beats per minute in the upper chamber of the heart. The lower chamber will always goes at a much lower than that. But patients who have atrial flutter usually have a very regular heart beat. Now atrial fibrillation is much faster than atrial flutter, and it's also much more chaotic than atrial flutter.

So typically atrial fibrillation will cause an irregular heart beat.

Now I think the most important difference between atrial flutter and atrial fibrillation is how they're treated in the role of catheter ablation. Catheter ablation is very successful and curative for many patients with atrial flutter, particularly if they have only atrial flutter and almost no or no atrial fibrillation.

Conversely catheter ablation, it plays a much smaller role in the treatment of atrial fibrillation the procedure is more difficult it's more risky and it has a lower success rate. So I think atrial fibrillation and flutter, you know they're similar in some respects, they're different in other respects. And the question is why do you have both atrial fibrillation and atrial flutter. And that can be explained by the fact that patients who have atrial flutter also commonly have some amount of atrial fibrillation that triggers the episodes of atrial flutter.

So a patient will have a brief burst of atrial fibrillation. And if that patient is also susceptible to atrial flutter which can start up atrial flutter which typically will continue for hours to days to weeks until something's done to stop it. It sounds like in your case, you have both atrial fibrillation and atrial flutter. And in patients who have about equal amount of atrial fibrillation to atrial flutter, those patients are treated as if they only have atrial fibrillation.

So in your case I would concentrate on treating atrial fibrillation and not focus on atrial flutter at this point. I guess one other similarity that I think is particularly important is both atrial fibrillation and atrial flutter will increase the risk of stroke and the indications for blood thinners are the same regardless of whether a patient has atrial fibrillation or atrial flutter.