A-Flutter

[lea99]

Dr.
Can A-Flutter cause damage to the heart muscle if the rate is controlled?

The A-Flutter is constant. Meds (Verapamil and Toprol) seem to be doing their job. But over time, if sinus rhythm is not restored, does this put an extra strain on the heart?

Can A-Flutter turn into A-Fib?
Does A-Flutter carry the same risk as A-Fib in terms of "remodeling"?
Is it possible for A-Flutter to resolve on it's own?

Thank you.

[Forum-M.D.-ppb]

The flutter, when well rate controlled, does not cause damage to the ventricles of the heart, the pumping chambers.  It may, however, cause damage to the atria, where the flutter actually takes place.  It may cause the atria to remodel making it more difficult to convert to NSR.  The longer one is in flutter, the harder it is to convert to NSR.  Therefore, younget patients benefit the most from aggressive therapy, be it medications that can convert you to NSR versus flutter ablation.  The medications you are on right now will only control the rate of your flutter, they are unlikely to convert you to NSR.  A flutter can turn into atrial fibrillation as well.  Again, the longer you are in flutter, the more likely you are to develop atrial fibrillation.  There are some reversible causes of atrial flutter such as thyroid abnormalitis or caffeine consumption or alcohol, however, for the most part once someone has flutter, even though, they may be out of it for some time, they usually develop it due to structural or valvular abnormalities of the heart, and we treat it as such.  The risk of thromboembolic complications (stroke, etc) is similar between flutter and atrial fibrillation.  We recommned anticoagulation.  Typically, flutter develops in those with CAD or HTN or valvular heart disease, and unless those are controlled or corrected it is unlikley that it will resolve by itself.

[Nitty49]

A related discussion, mini-maze was started.