Ms. Kieu was diagnosed with atrial flutter one year ago, receiving medical treatment in Vietnam and the United States. Atrial flutter is a common type of heart arrhythmia, causing a fast and unstable heart rate. She frequently experienced dizziness and developed heart failure complications, with her myocardial ejection fraction (EF) dropping from 60% at diagnosis to 40-45% after one year.

Recently, she was admitted to the emergency department at Tam Anh General Hospital, Ho Chi Minh City. Dr. Le Xuan Hoang, from the Interventional Cardiology Center, stated that the patient's arrhythmia had worsened significantly. Atrial flutter attacks consistently caused her heart rate to be 150-160 beats per minute. The myocardium had to contract continuously, leading to inefficient blood pumping and a severe drop in the patient's blood pressure, with systolic blood pressure at 70-80 mmHg (normal is 90-130 mmHg). Without proper treatment, atrial flutter can progress, causing shortness of breath, weakness, syncope, hypotension, heart failure, stroke, and vascular embolism.

Dr. Hoang determined that Ms. Kieu's atrial flutter no longer responded to medical treatment. He noted that cardioversion, which uses a defibrillator to reset the heart rhythm, would only provide temporary relief. The optimal solution was catheter ablation of the arrhythmia focus.

The intervention team performs catheter ablation for a patient with atrial flutter. *Photo: Tam Anh General Hospital*

Ms. Kieu initially received medical treatment with vasopressor drugs, which helped increase her systolic blood pressure to 90-95 mmHg. Subsequently, the medical team inserted a catheter from her femoral vein to her heart. Electrodes were guided to locate the atrial flutter isthmus, and radiofrequency energy was then used to ablate the myocardial tissue responsible for maintaining the atrial flutter.

Given the patient's history of asthma, an acute attack during the procedure could easily lead to respiratory failure, hemodynamic instability, and a risk of cardiac arrest. Therefore, an anesthesiologist was present in the intervention room, closely monitoring the patient's respiratory status.

After one hour, the doctors successfully performed the ablation, and the patient's heart rate returned to normal. Her hemodynamics stabilized immediately during the procedure. She was taken off vasopressor drugs the same day and discharged after two days.

Dr. Hoang checks the patient's health after the intervention. *Photo: Tam Anh General Hospital*

According to Dr. Hoang, most patients with atrial flutter initially choose medication after diagnosis. However, the success rate for stabilizing the rhythm and preventing recurrence with drugs is limited. Currently, the optimal recommended treatment method is catheter ablation for arrhythmia.

Many patients with atrial flutter experience no clear symptoms and remain unaware of their condition until a routine health check-up. Dr. Hoang advises that if symptoms such as palpitations, shortness of breath, chest pain, chronic fatigue, or syncope (common in patients with atrial flutter accompanied by heart failure) appear, individuals should seek medical attention immediately.

By Thu Ha