The Atria 300 Beat
In atrial flutter the atria beat about 300 times per minute – about 4 to 5 times faster than normal. Cardiologist, Dr Oliver Segal explains that, "Fortunately, most of the time not all of these signals conduct to the ventricles below, but the heart rate still increases to 150 per minute in healthy hearts. This can cause palpitations, breathlessness, dizziness or even collapse."
The problem is that when the atria beat 300 times per minute, blood can stagnate within them and this can lead to clot formation in the heart. When clots form here they can dislodge and travel through the heart and circulate to the brain, causing a stroke.
The scoring system to identify patients who are at risk of stroke when they have atrial flutter is called the CHA2DS2-VASc scoring system.
CHA2DS2VAScscore
The CHA2DS2VAScscore is an acronym. It stands for:
C = Congestive cardiac failure (or heart failure or impaired
ventricular function)
H = Hypertension (or high blood pressure)
A2 = Age over 75
D = Diabetes
S2 = Stroke or TIA (transient ischaemic attack, or ‘mini-stroke’)
V = Vascular disease (heart attack or other arterial disease)
A = Age below 65
Sc = Sex category (female = 1 point)
In his article, What is Atrial Fltter and how is it Treated, Dr Segal says, "If you have or have ever had one of these conditions you score one point for each, except Age over75 or Stroke/TIA which count as 2 points, hence the CHA2DS2VASCscore."
If you have a CHA2DS2VASC score of 1 or more it is recommended that you take warfarin (or one of the newer types of anticoagulant medications) for life to reduce your risk of stroke, unless the atrial flutter is cured with a procedure called ablation (see catheter ablation). So, if you are 65 or older and have atrial flutter, it is recommended that you are treated with an anticoagulant and not aspirin, which is now known not to be beneficial.
