An atrial flutter is an organized arrhythmia that occurs in the right atrium. The typical rate of atrial flutter in the atria is 300 beats per minute. These impulses typically travel through the AV node in a regular fashion. For example, if every other atrial flutter beat travels through the AV node to the ventricles, the heart rate is 150 beats per minute (300 divided by 2 = 150). If every 3rd beat gets through the AV node, the heart rate is 100 beats per minute. Atrial flutter can be associated with symptoms of palpitations, shortness of breath, dizziness, and lightheadedness but patients can also be asymptomatic. Atrial flutter is similar to atrial fibrillation (AF) in many respects. It is most common in patients with heart disease although it can also be seen in patients with normal hearts. Therefore, a thorough workup should be performed to attempt to identify any heart disease that might be present. It is also associated with an increased risk of stroke and anticoagulation is typically necessary (with warfarin). A cardioversion is typically necessary to restore normal rhythm. Atrial flutter is often seen in combination with atrial fibrillation (both arrhythmias occur in patients with abnormal hearts). Unlike atrial fibrillation, atrial flutter can be cured a large majority of the time (>90%) with radiofrequency catheter ablation. It is important to realize that this procedure does not typically eliminate atrial fibrillation in patients with both AF and atrial flutter. The exception to this is in the patients in which atrial flutter degenerates (changes into) atrial fibrillation. In these cases, curing the atrial flutter has the potential to reduce the number of episodes of AF or to potentially eliminate the AF altogether. If AF occurs after an atrial flutter ablation then anticoagulation is usually necessary. If a patient is not a candidate for a catheter ablation then medications will likely be needed to either maintain a normal rhythm or control the heart rate.