Atrial Flutter
Treatment

The treatment for your child's atrial flutter will depend on the type and severity of the condition and the results of various diagnostic tests, such as the electrophysiology (EP) study. You and your doctor will decide which treatment is right for your child.

The following treatments may be considered:

Medications

Certain anti-arrhythmic drugs change the electrical signals in the heart and help prevent irregular or rapid heart rhythms from occurring. Medication may be used to convert atrial flutter to a normal rhythm, slow down the heart rate or prevent recurrences. If medication is ineffective, the doctor may try to stop the atrial flutter with pacing or with an electrical cardioversion.

Cardioversion

This is the delivery of an electrical shock to the heart using a medical device called a defibrillator. The shock is delivered through pads or paddles placed on the chest. On occasion, cardioversion is performed as an emergency procedure when the heart is beating so fast that the patient cannot maintain a stable blood pressure. The electrical shock will cause the fast rhythm to stop and the heart to restart in a regular rhythm.

If the patient is stable and can tolerate the rhythm, the cardioversion is scheduled ahead of time. Prior to the scheduled cardioversion, it is often necessary to run tests to make sure that there are no blood clots in the heart. Some people need medication to "thin" their blood before having the cardioversion.

For a scheduled cardioversion, the patient is sedated beforehand and his or her breathing is assisted. The electrical shock usually makes the patient's heart convert back to a normal rhythm. Afterwards, to decrease the likelihood of the arrhythmia returning — or to prevent blood clots from entering the general circulation — your doctor may recommend a medication regimen.

Follow-up Electrophysiology Study

To make sure that your child's medication is working properly after two or more days in the hospital, your child may be brought back to the Electrophysiology Laboratory for a follow-up electrophysiology (EP) study. Our goal is to find the medication that works best for your child. On occasion, we admit children to the hospital and monitor their heart rhythm while we start the medication.

Radiofrequency Catheter Ablation (RFA)

Radiofrequency catheter ablation (RFA) is a technique to treat arrhythmia that was pioneered at UCSF Medical Center. It disrupts part of the electrical pathway causing irregular heart rhythms, providing relief for patients who may not respond well to medications, who prefer not to take medications or who can't take medications.

The procedure involves threading a tiny metal-tipped catheter through a vein or artery in the leg and into the heart. Using fluoroscopy or X-ray, doctors guide the catheter through a blood vessel to the heart. Additional catheters, inserted through the vein in the leg and the neck, contain electrical sensors to find the area causing the arrhythmia. This is called mapping.

The metal-tipped catheter is maneuvered to each site in the heart that causes the irregular heartbeat. Radiofrequency waves or current is sent through the tip of the catheter, cauterizing or burning cells to destroy the extra electrical pathways that cause abnormal heart rhythms. In most cases, patients leave the hospital within 24 hours or the same day.

RFA has been proven very effective in treating children with arrhythmias. Your doctor will discuss this treatment and others with you to decide the best option for you or your child.

Cryoablation

Cryoablation, sometimes referred to as cryo, is similar to radiofrequency catheter ablation (RFA) in that it is a procedure that disrupts the abnormal electrical pathway in the heart. Instead of burning cells, however, cryoablation destroys cells by freezing them. This newer technology has been used in the Electrophysiology Laboratory at UCSF Benioff Children's Hospital since March 2004.

Cryoablation has been very effective in treating children with arrhythmias. Your doctor will discuss this treatment and others with you to decide which method is the best option.

Like RFA, cryoablation involves threading a tiny metal-tipped catheter through a vein or artery in the leg and into the heart. Doctors guide the catheter through the blood vessel to the heart by using fluoroscopy or X-ray.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

Related Information

UCSF Clinics & Centers

Heart Center

Arrhythmia Center
1825 Fourth St., Sixth Floor
San Francisco, CA 94158
Phone: (415) 514-2783
Fax: (415) 353-4144
Appointment information

Pediatric Heart Center Clinic at Mission Bay
1825 Fourth St., Sixth Floor
San Francisco, CA 94158
Phone: (415) 353-2008
Fax: (415) 353-4144
Appointment information

Cardiac Intensive Care Unit
1975 Fourth St., Fourth Floor
San Francisco, CA 94158
Phone: (415) 353-1955
Fax: (415) 353-9144