What is "atypical atrial flutter?"

"Atypical atrial flutter" was the diagnosis printed on the "after visit summary" I received when I left the check- out desk.

He never explained it to me in person and didn't show me what it meant on the EKG during my last office visit. I just noticed it on the print out.

It will take me forever to get an explanation by phone. I will have go through numerous "firewalls" of NP's and PA's and hope that they will call back.

Does anyone know what it is?

Carol

Typical atrial flutter is caused by a signal going around the right atrium. So if you're facing a person and that flutter wave a visible light, you would see a light going around in a circle like a clock on the wall (it might be going counterclockwise but that would still be typical).

Atypical flutter is when that flutter wave is revolving anywhere else. Merely being in the left atrium makes it atypical, but it can be almost anywhere else and what you would see with that visible light analogy is a flutter wave going in a circle but instead of looking like a clock on a wall it might look like a clock lying flat on a table, or a clock tilted at an angle.

The only practical difference between the two is that typical flutter is relatively easy to ablate, but atypical flutter may or may not be. It took 7 years, 6 ablations, and 4 EPs to correctly find and ablate my atypical flutter (I had multiple atypical flutter circuits on both sides).

I’m not sure how you diagnose atypical flutter just from an EKG. Like Carey said, it’s probably left-sided but that really requires a mapping catheter inside the heart to figure that out and that’s part of a flutter ablation that can often last hours.

Hi Carola,

I have had 5 ablations 3 for AFIB/Right Sided Flutter and two for Left Sided Flutter. The Left Sided Flutter's started very soon after successful AFIB ablations which apparently is not uncommon. Until reading Carey's post above I though all Atypical Flutter was Left Sided Flutter.

Almost 10 years after the last ablation by Prof Jais in Bordeaux, which was for Left Sided Flutter, I suddenly developed 'Flutter' after working out in the gym 7 month ago and though it was a 'slow' flutter of only 80 BPM resting it would rise rapidly when just walking to around 120BPM which was very uncomfortable and stopped all thoughts of exercising..

The local EP here in Hong Kong said yes it was Flutter however until he went inside my heart he could not tell whether it was Right Sided Flutter or Left Side Flutter confirming Wolfpack's post above.

Given that Prof Jais said he 'could not get it all' at that last ablation I strongly believe that the Flutter appearing in the gym was Left Sided Flutter a very different animal than Right Sided Flutter. From what I can gather and from what I experienced Left Side Flutter is dramatically harder to ablate than Right Sided Flutter and that being the case should Flutter return -stopped by cardio-version 5 months ago - I would be looking at returning to Bordeuax as my EP here in HK virtually admitted his experience with LAFL was minimal as almost to a man the local Chinese people would without doubt take a pill before an ablation.

Cheers,
Barry G.

Barry,

Just out of curiosity, I wonder what the incidence of Afib, Flutter, etc. is in the Chinese population?

Furthermore, I believe that they use a lot of MSG in their food, which some people think predisposes to Afib.

Carol

My flutter was being triggered from my Coronary Sinus. I was in it when I went on the table with Natale and he ablated the spot causing it.

I was told by an EP that my atypical atrial flutter was starting in the scar tissue of my ablation. This started happening about seven years after my ablation. I now get more flutter episodes than fib episodes. Now on list to have flutter ablation;