No Symptoms but 17 hours of Atrial Flutter!!!

O.M.G. !!! I just got a call from Alaska Heart Institute - they implanted pm for CRT 6 yrs ago & no problems (couple adjustments at device clinics) until last week 9/11 the bedside monitor transmitted 17 hrs of Atrial flutter.  I'm 59. I have no recollection of any symptoms - I went to pool - aquasize & work (front desk at museum), home, work the next day. Yikes I'm scared to point of having a panic attack.  just saying/admitting.that reduces my anxiety a little but ... 17 hrs of flutter?!! They are setting up an appt in a couple weeks. I'm in the parking lot of Library. Can't sit here forever. Thanks for letting me talk. I don't have any pm friends here & you're all very supportive.


5 Comments

Settle down. There is no emergency here.

by AgentX86 - 2018-09-18 23:57:35

The important part is to get on anticoagulents and make sure your heart rate is taken care of (less than 100 when resting).  Pronto - like right now!

Flutter is like Afib in that, by itself, isn't dangerous (I've been in constant flutter for a year and a half).  The two problems are blood clots (stroke) and V-tach => V-fib.  You stay out of V-tach by slowing the AV node down so the atrial tachacardia can't reach the ventricles.  The atria will be beating at 240-300bpm and, of course, if that hit the ventricles you'd be dead.  Fortunately, the AV node won't let that happen.  A beta blocker or calcium channel blocker is a good insurance policy.  High resting heart rates will cause and enlarged heart, too, but that's a longer term problem.  Again beta blockers and CCBs will keep this from happening, too.

Since you're obviusly not symptomatic, the longer term solution isn't so clear.  There may be no reason to get you out of AFL at all. A cardioversion might be worth a try but it's not likely to work (I'm a rare case where it did for seven years). You can try drugs but antiarrhythmetics are all really nasty, with very bad side effects and limited useful life (they tend to work for a while, then not so much).  Ablations work but if you're asymptomatic, why bother?  There are even more drastic measures available (been through them all) but again, it's not ruining your life, so why bother?

Once you get the heart rate under control and get on an anticoagulent, you'll have plenty of time to discuss your options with your EP.  ...and you NEED a really good EP for Aflutter!

I know how you feel

by IAN MC - 2018-09-19 08:14:22

One minute everything is fine and suddenly it's not !    Atrial flutter , like other arrythmias suddenly strikes without any warning .   ... just like a fault developing in your TV really.

Of all the arrythmias, atrial flutter is one of the easiest to treat though and even though you are symptom-free you may decide that you would rather have normal sinus rhythm .

I agree with Agent , consider the options and then make a decision as to which treatment you want to try.   You will be offered drugs, cardioversion or a flutter ablation and each has its pros and cons.

When I developed atrial flutter 7 years ago I decided that making my treatment choice was a no-brainer. After a week on drugs I opted for an ablation . This CURED me (  which it does in  95% of cases) , restored normal rhythm and I immediately stopped taking the anti-arrythmic drugs AND the blood-thinners which was important to me.    

But, we are all different , with different priorities in life and the fact that you are symptom-free will inevitably affect your decision. 

Best of luck and do come back to us when you are nearer decision-time.

Ian

Flutter isn't always easy to treat.

by AgentX86 - 2018-09-19 09:40:18

I started with Afib, then has a Maze, which left me with atypical flutter (left atrium). I was highly symptomatic, so went through several antiarrhythmics, three ablation attempts, and finally an AV ablation and pacemaker. The drugs caused thyroid problems (since dissipated) and sick sinus syndrome. I'm still in flutter 100% of the time but don't feel it (much) because of the AV ablation.

Flutter can be a real bitch. Like AFib, if you're not symptomatic,  it's not a big deal. Remember, the cure CAN be worse than the disease. If you can't live with the _symptoms_ then pursue these therapies. It's a quality of life issue, not life or death.

 

Should've said.......

by IAN MC - 2018-09-19 10:06:00

mine was a " typical" atrial flutter as opposed to an " atypical" one which Agent had.      The designation depends on the nature and location of the rogue electrical circuit.

You need to find out which type you have as " typical" flutters respond really well to ablations and " atypical' ones less so.

Cheers

Ian

Thank You!!

by kbayalaska - 2018-09-19 19:28:06

Ian MC & AgentX86-- Big Thanks for your responses. They were very reassuring. I'm 200  miles from my MD who is also an EP.  Getting an appointment difficult - will be about 4-5 weeks so I will keep doing what I'm doing and make decisions when more info is known. Thanks again!

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