Atrial flutter is a usually regular rhythm which typically involves a circuit with anticlockwise rotation around the right atrium. It can be paroxysmal but more often is persistent and can be difficult to terminate with drugs. Cardioversion is usually required.

Ablation carries a high success rate, invovling lines placed in the narrow corridor between the tricuspid valve and inferior vena cava.

Atrial flutter carries as much a stroke risk as atrial fibrillation and the same approach to anticoagulation should be made