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Medications may be used to treat some patients with atrial flutter. Medications such as beta-blocking agents such as atenolol, metoprolol, or carvedilol, calcium channel blocking agents such as diltiazem or verapamil, or digoxin may be used to decrease the number of beats that travel from the atria to the ventricles, thus, decreasing the ventricular heart rate. In addition, some patients may benefit from medications that stabilize the atria. These medications, called anti-arrhythmic agents, include sotalol, dofetilide, propafenone, flecainide, dronedarone, or amiodarone. The choice of the medication depends on the presence of heart problems, blockages in the arteries to heart, and other factors. In some cases, an electrical shock to the chest, called cardioversion, is used to convert the rhythm to normal. As an alternative to these medications, a technique called catheter ablation may be used to prevent atrial flutter, usually without the need for medications. In most patients, there is specific path that the electrical signal takes with the atria that is responsible for the atrial flutter. In most cases, there is a specific path or alley-way that is necessary for the atrial flutter to continue. In such cases, creating a series of energy deliveries that kill islands of cells responsible for conducting the electrical signals may prevent atrial flutter. Catheter ablation for atrial flutter in most patients is effective in over 80-90% of cases. Some patients with atrial flutter may develop atrial fibrillation in the future.
In some cases, particularly patients with prior heart surgery or catheter ablation, there may be multiple electrical pathways. Frequently patients with atrial flutter will be treated with anticoagulation with warfarin to prevent blood clots and stroke.