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Atrial and Supraventricular Tachycardia (SVT) Flutter

Your heart has four chambers: the left and right atria, on the top, and left and right ventricles, on the bottom. To pump blood, each chamber has to squeeze in and out at just the right moment. To time all of this just right, your heart has a cluster of cells that sends little electrical impulses to each chamber. Sometimes those signals don’t move the way they should. That’s where atrial SVT flutter might come in.

Atrial and supraventricular tachycardia (SVT) flutter is a fast heart rate that begins in the heart's upper chambers (atria). Abnormal electrical connections in the heart cause it to beat fast or irregularly. You can say that Atrial flutter comes from a "short-circuit" in the right atrium. This short-circuit causes the atria to beat at about 300 beats per minute while the lower chamber of the heart (the ventricles) beats at a slower rate (often 75 to 150 beats per minute). This causes the heart to beat inefficiently, and reduces blood supply.

Atrial fibrillation is sometimes confused with atrial flutter because it is also a common heart rhythm problem. But it is not considered a type of SVT. Unlike the more irregular atrial fibrillation, atrial flutter beats in a regular rhythm.

What happens once you have atrial and SVT flutter?

Many types of arrhythmia are not serious. Other types may cause the patient to develop heart failure, pass out or, in rare cases, to die suddenly.

Atrial and SVT flutter occurs most commonly in elderly patients and those with other types of heart disease. It can cause a wide variety of symptoms and increase the risk of developing a stroke.Some people have no or minor symptoms. If you do have symptoms, they can include:

  • Fainting.

  • Chest pain.

  • Shortness of breath.

  • Tiredness (fatigue).

  • Lightheadedness.

  • Fluttering heartbeats (palpitations).

  • Swelling in your feet and legs (fluid retention) if you have heart failure.

What causes atrial and SVT flutter?

Here are some common things that trigger SVT:

  • Caffeine or alcohol: Caffeine can set your heart racing. It is found in tea, chocolate, and energy drinks. Alcohol can also be a trigger.

  • Surgical scarring: If you've had heart surgery, you may be left with scars in your heart that increase the chances you may get SVT. Up to 25% of people who've had a heart transplant will have this happen. This doesn't mean your body is rejecting the new organ.

  • Medications and stimulants: Certain medications have been known to trigger the pounding heart rhythm of SVT. These include medications for treating heart failure, asthma, other lung problems, decongestants, antihistamines, and illegal drugs like cocaine, ecstasy, or methamphetamine.

  • Stress: If you are worn out or anxious, you may be more likely to have SVT.

These risk factors make you more likely to have atrial flutter:

  • Diabetes.

  • Obesity.

  • Heart failure.

  • Lung disease.

  • Sleep apnea.

  • Family history.

  • Heart valve disease.

  • Past heart surgery.

  • Coronary artery disease.

What types of tests are used to diagnosis atrial and SVT flutter?

To diagnose atrial flutter, your doctor will want to record your heart rhythm with any of these tests:

  • Electrocardiography (EKG): This measures the electrical activity in your heart through tiny patches placed on your chest. The patches are connected to a machine that records the heart rate.

  • Holter monitoring: This is a portable EKG that you can wear to record your heart rhythm 24 hours.

  • Event monitoring: This type of EKG samples your heart rate over several days.

It can be hard to capture atrial flutter when it happens on and off or only lasts a few minutes. The longer the recording time of heart rhythm, the higher the chance atrial flutter can be recorded.

What types of treatments and procedures are used to treat atrial and SVT flutter?

Most cases of atrial and SVT flutter don't need to be treated. They go away on their own. But if an episode doesn't end within a few minutes, some possible treatments include:

  • Medications: You might get a shot of a fast-acting medicine to block the electrical impulses causing your heart to race. Possible medications include “calcium-channel blockers” or “beta-blockers” and medications that treat abnormal heart rhythms.

  • Catheter ablation: Your doctor destroys the tissue in your heart that is causing it to beat too fast with an electrode at the end of a catheter. This procedure is usually successful and has few side effects.

  • Cardioversion: A small electrical current is applied to your heart to reset its beat in this procedure. The doctor can deliver it through hand-held paddles, called a defibrillator, or patches put directly on your chest.

  • Pacemaker: This small device keeps your heart beating evenly.

  • Lifestyle changes: You may be able to prevent your heart from racing by reducing or cutting out caffeine, alcohol, tobacco, diet pills, and any stimulant, even those found in decongestants.

  • Treating underlying problems: Sometimes, another health condition causes SVT. Treat that condition before you can get your atrial and SVT flutter under control:

    • Coronary artery disease (blocked, inflamed, or narrow arteries).
    • Hyperthyroidism (an overactive thyroid).
    • Lung disease.
    • Wolff-Parkinson-White Syndrome (an electrical pathway problem present from birth).

What can I do to support my health when I have an atrial and SVT flutter?

Prevention of atrial and SVT flutter focuses on controlling or preventing risk factors:

  • Stop tobacco use.

  • Maintain a healthy weight.

  • Drink alcohol only in moderation, if at all.

  • Control high blood pressure and diabetes.

Complications of atrial flutter can be serious if left untreated. See your healthcare provider if you notice any symptoms of atrial flutter.

Why choose Presbyterian for atrial and SVT flutter treatment?

Presbyterian’s Heart and Vascular team has many different options to help you manage your heart condition. The team performs various diagnostic tests and procedures to help form an accurate diagnosis and create individualized treatment plans for your heart health needs. Depending on the type of heart condition you have and its underlying cause, the team can recommend a wide variety of treatment options, including lifestyle modifications, medications, and procedures. Our cardiologists and cardiovascular surgeons work closely together for cases in which surgery is the best treatment option. We also offer a customized cardiac rehabilitation program at our Healthplex, where clinically appropriate, which can improve your endurance and exercise tolerance, as well as improve heart-related symptoms. Your cardiologist will work with the rehabilitation team to create a plan that will be tailored to your individual health needs.