What's the Difference Between Atrial Flutter and Atrial Fibrillation?

Atrial flutter and atrial fibrillation (AFib) are heart rhythm conditions that occur when the upper chambers of the heart (known as the atria) beat too quickly. Atrial flutter involves the atria beating very quickly but in a regular pattern, whereas AFib causes rapid and irregular heartbeat patterns.

Both conditions can lead to poor blood flow, heart palpitations, and shortness of breath.

Symptoms of Atrial Fibrillation vs. Atrial Flutter

Many heart conditions have similar symptoms, and the same is true for AFib and atrial flutter. These symptoms can also worsen as the conditions progress. Here's a full breakdown of how symptoms for both conditions compare:

Differences

While atrial flutter and atrial fibrillation are each conditions that involve the atria (the heart's upper chambers), there are some differences between the two conditions.

They Have Different Heart Rate and Rhythm Patterns

In AFib, the atria of the heart do not contract in an organized way. Instead, they quiver or shake. This causes the heart’s lower chambers (ventricles) to beat irregularly and often too fast. People with AFib often have a pulse that feels irregular and inconsistent, with a heart rate that may be above 110 beats per minute.

However, with atrial flutter, the atria beat very quickly, up to 300 beats per minute, but in a regular pattern. The ventricles don't beat as rapidly but usually have a rate of 150 beats per minute. This rapid beating can still make the ventricles beat faster than normal, but the rhythm is more organized than AFib.

Atrial Fibrillation May Have Genetic Causes

Atrial flutter is not genetic. However, some research has found that AFib can sometimes be caused by genetic mutations that affect the heart's electrical system. These mutations can change how certain proteins in the heart work, which can sometimes lead to AFib.

Studies have also explored how often these genetic changes occur and how they contribute to the development of AFib, but more research is still being conducted to understand which genes are associated with the condition.

Risk Factors for Atrial Flutter and Atrial Fibrillation Differ

Atrial flutter and AFib have some similar risk factors, like high blood pressure, diabetes, older age, and alcohol use. But there are other risks for both. The risk for atrial flutter increases among people assigned female at birth. On the other hand, the risk of AFib is more common in people with underlying heart disease, a family history of AFib, sleep apnea, and being an athlete. AFib can also be linked to other chronic conditions like an overactive thyroid and asthma.

Similarities

While both conditions affect the same part of your heart, there are other several other similarities between them.

They Both Increase the Risk of Stroke

Both atrial flutter and AFib increase the risk of stroke. People who live with either condition may need medications called blood thinners to prevent blood clots and reduce the risk of stroke. About 15-20% of people who have strokes also have an underlying diagnosis of AFib.

Prevention Methods and Treatment Options Are Similar

It’s possible to manage atrial flutter and AFib with lifestyle changes, such as maintaining a weight that's right for your body, avoiding alcohol, quitting smoking, and managing stress. When lifestyle changes are not enough, medications can help control heart rate and rhythm.

Procedures like electrical cardioversion (restores normal heart rhythm) and ablation (destroys damaged heart tissue) can also reduce symptoms of both conditions. In some cases, a repeat ablation may be needed if symptoms return.

The Diagnostic Process Is Often the Same

If you're experiencing symptoms of either atrial flutter or atrial fibrillation, it's important to see a healthcare provider sooner rather than later to receive a diagnosis and get treatment if needed. The diagnostic tests that healthcare providers use for either condition are similar.

You can expect your provider to check for signs of fluid buildup, listen to the lungs for signs of heart failure, assess the veins in your neck for swelling, detect crackling sounds in the lungs, and analyze any swelling in your abdomen and legs. In many cases, you'll also need additional exams, such as blood tests and an echocardiogram.

Can You Have Both Atrial Flutter and Atrial Fibrillation?

Atrial flutter and AFib can coexist, meaning you can experience symptoms of both conditions simultaneously. This coexistence, however, can complicate diagnosis and treatment. Managing both conditions requires a comprehensive approach by a healthcare professional to control heart rhythm and rate and prevent complications such as stroke.

When To Seek Care and Who to Contact

If you have symptoms of atrial flutter or AFib, such as palpitations, shortness of breath, dizziness, fatigue, or chest pain, you should visit your healthcare provider. It's also important to seek medical attention if these symptoms are new, severe, or worsening.

At first, you'll work with your primary care provider. If you receive a diagnosis, you'll likely be referred to a cardiologist (a doctor who specializes in the heart) for guided treatment.

Immediate medical care is necessary when having chest pain or pressure, as this could indicate a heart attack.

A Quick Review

Atrial flutter and atrial fibrillation (AFib) are two types of heart conditions that can cause the upper chambers of your heart (known as the atria) to beat rapidly. These two conditions differ because AFib has an irregular rhythm, while the rhythm of an atrial flutter is more organized.

Both conditions cause similar symptoms, such as heart palpitations, shortness of breath, and anxiety. Treatments like medications, lifestyle changes, and procedures can improve symptoms and lower the risk of complications.