Anti-arrhythmic drugs of type IA (e.g. quinidine) or IC (e.g. propafenone) can effectively revert atrial flutter and prevent recurrence. However, ventricular rate should be slowed down by digitalis, calcium channel blockers or β-blockers beforehand, otherwise, the ventricular rate will be accelerated due to the slowing down of atrial rate and anti-vagal effect of quinidine. If a patient with atrial flutter is combined with coronary artery disease and congestive heart failure, the application of class IA and IC drugs may easily lead to severe ventricular arrhythmias. In this case, amiodarone should be used, which is effective in preventing recurrence of atrial flutter. Sotalol can also be used for the prevention of atrial flutter, but should not be used in patients with myocardial ischemia or left ventricular insufficiency. If atrial flutter persists, neither class I nor class III drugs should be used continuously. The goal of treatment is to slow down the ventricular rate and maintain hemodynamic stability. Radiofrequency ablation can cure atrial flutter radically. Because of the limited efficacy of drugs for atrial flutter, radiofrequency ablation should be the treatment of choice for atrial flutter that is symptomatic or causes hemodynamic instability. Amiodarone is a multi-channel blocker, a class III drug, which blocks ⅠKr, ⅠKs, ⅠKur, background potassium flow (ⅠK1), but also ⅠNa, ⅠCa-L. Therefore, it is currently a better antiarrhythmic drug, with the disadvantage of more extracardiac side effects, probably related to its molecular iodine content.