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Dr. Douglas L. Packer, MD, FHRS, Mayo Clinic, Rochester, MN

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Jill and Steve Douglas, East Troy, WI 

“I really appreciate all the information on your website as it allows me to be a better informed patient and to know what questions to ask my EP. 

Faye Spencer, Boise, ID, April 2017

“I think your site has helped a lot of patients.”

Dr. Hugh G. Calkins, MD  Johns Hopkins,
Baltimore, MD

Doctors & patients are saying about 'Beat Your A-Fib'...

"If I had [your book] 10 years ago, it would have saved me 8 years of hell.”

Roy Salmon, Patient, A-Fib Free,
Adelaide, Australia

"This book is incredibly complete and easy-to-understand for anybody. I certainly recommend it for patients who want to know more about atrial fibrillation than what they will learn from doctors...."

Pierre Jaïs, M.D. Professor of Cardiology, Haut-Lévêque Hospital, Bordeaux, France

"Dear Steve, I saw a patient this morning with your book [in hand] and highlights throughout. She loves it and finds it very useful to help her in dealing with atrial fibrillation."

Dr. Wilber Su,
Cavanaugh Heart Center, 
Phoenix, AZ

"...masterful. You managed to combine an encyclopedic compilation of information with the simplicity of presentation that enhances the delivery of the information to the reader. This is not an easy thing to do, but you have been very, very successful at it."

Ira David Levin, heart patient, 
Rome, Italy

"Within the pages of Beat Your A-Fib, Dr. Steve Ryan, PhD, provides a comprehensive guide for persons seeking to find a cure for their Atrial Fibrillation."

Walter Kerwin, MD, Cedars-Sinai Medical Center, Los Angeles, CA

FAQs Coping with A-Fib: A-Flutter

red-heart-negative 150 pix by 96 res

I received an email from Jack Owens asking about Atrial Fiutter and our coverage of the topic on Here’s what he asked me, followed by my reply:

“I have A-Flutter and not A-Fib. Can I assume that most of the topics discussed on this site apply to both A-Fib and A-Flutter? I would very much like to see more information on your site about A-Flutter. There are a lot of us out here with it. Your web site is the best by far I have found on this subject.”

Atrial Flutter a Form of A-Fib

Consider Atrial Flutter as a milder, more organized form of A-Fib. However, because Flutter is more organized and regular, it often makes the ventricles beat faster. Sometimes it’s harder to control the pulse rate of Flutter compared to A-Fib.

During a catheter ablation for A-Fib, as the electrophysiologist (EP) ‘isolates’ A-Fib areas, the patient’s heart often progresses or improves into Atrial Flutter, then into tachycardia, and finally into normal sinus rhythm (NSR).

ECG: example of heart in A-Fib (actual pattern will vary)

ECG: Example of heart in A-Flutter (actual patterns will vary)

ECG: Heart in normal sinus rhythm

Flutter and Atypical Flutter

There are basically two forms of Atrial Flutter:

 Atrial Flutter: Comes from the right atrium and is easily isolated by what is called a ‘Caviotricuspid Isthmus line ablation’ of the right atrium. This is a very simple procedure which can take as little as 10 minutes to complete. It’s often done in addition to an ablation for Atrial Fibrillation either before or after leaving the left atrium.

Atypical Flutter: A second type is often called “atypical Flutter.” At the end of a more complex catheter ablation, sometimes a patient remains in ‘atypical’ Flutter. This Flutter circuit can be difficult to map and isolate and is often one of the hardest arrhythmias to find and fix.

Often when I talk with patients with atypical flutter, I recommend them to Master EPs who have special mapping and ablation skills and more experience.

Flutter Can Be Considered a Form of A-Fib or Related to A-Fib

Almost every article on can also relate to Atrial Flutter. It’s true, we often don’t mention Atrial Flutter specifically. But Atrial Flutter is often related to and can be a form of Atrial Fibrillation.

In fact, a patient’s Atrial Flutter may mask that they also have Atrial Fibrillation. Likewise, as many as half of all patients who have an ablation specifically for Atrial Flutter, later develop Atrial Fibrillation.

For more, read my article: Atrial Fibrillation and Atrial Flutter: Cause and Effect

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