What is the difference between paf and flutter

[Chris147]

I love this forum you learn so much but I have Paf what is flutter?. I have never been offered an ablation but it seems that many are. I am doing fine on my meds flecainide 2 x 50 bisoprolol 5 amlodapine 5 statins not so good warfarin but will think about changing it. Am I missing out not having an ablation I am 62 but my cardiologist said we have a long way to go meaning I am on low amounts of drugs. I just read a blog about flecainide impacting on the brains immune system? I just asked my gp about being on flecainide he did not seem perplexed at in the least. So should i just carry on as apart from tiredness can get on with work etc. Many thanks as always for your support. Chris

[PeterWh]

Ask for a referral to an EP to get a proper assessment.

[Chris147 in reply to PeterWh]

I did and my cardiologist said I was doing fine and Ep just want to stick wires in you. I think I took that as at the moment I was being managed well. However when I appeared in resuscitation twice in three weeks 2014 he had mentioned ablation but to be fair I have been good no a and e so perhaps I m the best it's going to be which is good in reality. It's the long term dependency upon drugs and side effects that I think about. Thank you for your response. Chris

[PeterWh in reply to Chris147]

Sorry you but I think that you have a complete misconception. An EP is a cardiologist who has specialised in the heart electrics. They are not like secondhand car salesmen. None of the procedures involve sticking electrical wires in you unless you are being fitted with a pacemaker. There are thousands of people who see an EP who do not have an ablation. The waiting lists for ablations are already very long, some on here have quoted 12 to 18 months. EPs want to reduce their lists. If EPs put everyone on their list who they saw the lists would get longer.

You should be aware that some general cardiologists are biased against EPs and other specialists. Not invented here syndrome? Wasn't in my day syndrome? Some of that is human nature.

BobD often states an EP is the electrician of the heart and blood systems and a general cardiologist is the equivalent of the plumber. However I have just thought of a better analogy that applies to some cardiologists in that they know a little about the electrics but overall not a lot. When your washing machine electrics break down do you call in a general electrician who may (some don't) know a lot about electrics or do you call in a washing machine technician?

[BobD Volunteer]

To answer your prime question, Atrial fibrillation is when the left atrium goes into chaotic spasms and writhes like a bag of worms rather than pumps blood down to the left ventricle. Paroxysmal AF is when it comes and goes on its own.

Atrial flutter takes place in the Right atrium which contracts very quickly but not in a chaotic fashion. Flutter can be transferred across to the left and cause fibrillation to start but not always.

Both are electrical malfunctions in an often otherwise healthy heart.

Hope that helps but do read as much as you can from the main AF Association website where there are loads of fact sheets available.

[Chris147 in reply to BobD]

Thank you Bob

[Chris147 in reply to BobD]

Thank you Bob

[Rellim296]

Hi there Chris. A few comments:

1. I am glad I moved from Warfarin to a NOAC. It has been life changing.

2. I wish I had not taken flecainide for so long and I'm thrilled that I've been able to give it up.

3. I think your GP may not know all there is to know about flecainide

4. Is your cardiologist the best person to advise you about an ablation?

5. I wish I had seen my EP sooner and had gone down the ablation route earlier.

6. My life is a thousand times better than it was two and a half years ago and I am so grateful that the opportunities available today came my way.

[Chris147 in reply to Rellim296]

I am so pleased you are doing so well it is encouraging. I suppose this is twofold one my symptoms are much better and apparently much of my problems is stress. I am a social worker in a position of safeguarding children secondly I have just lost my mother funeral just before Christmas a terrible 11 years of alzheimers bless her. Gone down to 3 days working so I am hopeful with less stress my symptoms will be abated with meds. Secondly i am scared to have it done although so many people describe different experiences. I am of the mind to come off warfarin as I am back to weekly visits. Thank you for your comments really helpful. Regards Chris

[Rellim296 in reply to Chris147]

Oh, what a prolonged difficult time with your mother and a demanding job on top - though a rewarding one when things go well I am sure. Getting rid of warfarin could reduce your stress quite a bit. It certainly did for me!

Ablation is a scary prospect. The second time particularly I was quite sure it might go very pear shaped, but I am really glad I went ahead as it improved my life so much.

I have had three ablations with no pain or discomfort, nothing going drastically wrong and no difficulties to contend with. I just wish I'd not let things slide for three years on increasing amounts of medication between the first and the second.

[Chris147 in reply to Rellim296]

I agree in 20q4 three admissions to a and e felt my life was over in the sense of how I had lived my life. Took a long time to get meds sorted every time I went in a and e someone added or subtracted. When I finally sat with the cardiologist and cried like a baby that I needed someone at the helm it seemed to hit a note. So over a year no a and e a few ectopic but as he said I would still take statins I would still take anti Co still take blood pressure meds which probably would be amlodapine and bisoprolol. AAnyway I seem to be managed at the moment. No alcohol no late nights and trying to be mindful and live in the moment.

[Rellim296 in reply to Chris147]

Sounds like things are under control, and have moved forwards in several ways too.

[Buffafly]

I was surprised to be offered an ablation when I had been pootling along OK (mostly) on a low dose of medication for many years.

However thanks to this forum (yay!) I have learned a lot and one of those things is that cardiologists are not always up to speed on latest developments in AF treatment. My cardiologist said that ten years ago he would have only offered me a pacemaker because my heart was pausing but things have changed and he advised an ablation for af and flutter as the first step. As I am 70 and have what are charmingly described as comorbidities I have not found the ablation as easy to recover from as many younger people seem to.

So obviously I would back up the idea of consulting a EP asap!

[Chris147 in reply to Buffafly]

Thank you

[howesgilly]

Hi. You sound like you are on alot of medication and still not fully controlled. Flecainide has long term side effects too- this was explained by my ep when we were contemplating the risks of ablation against the risks of the medication. I would ask again about ablation. I only had paroxysmal af and not too frequent either but was very quickly referred for Ep opinion and haven't looked back so far.

Worse thing they can say is you are not suitable and to carry on with the meds

Xx

[Chris147 in reply to howesgilly]

Very good advice thank you

Regards

Chris

[Gracey23 in reply to howesgilly]

I am on 300 mgs of Flecanaide and after being on this forum am getting more and more afraid of this drug. I have PAF with no other health issues and would love opinions about continuing med vs ablation. I had an ablation 3 years ago for flutter but I know AFib ablation is a bigger procedure and not always successful.

[PeterWh in reply to Gracey23]

Go and see your GP to get a referral to an EP. If you were happy with your last one then go and see them, even if it is not your nearest.

Personally I decided on the ablation route. Had my first but went back into AF (as was predicted) less then 72 hours later. Waiting for second. As my GP said an ablation has to be a significant option if it means that no or fewer medicines need to be taken.

[Chris147 in reply to PeterWh]

Never seen an Ep my cardiologist said I didn't need to he is the main consultant at my local hospital and private hospital. I suppose I trusted him and I am doing pretty well just thinking about long term now.

[PeterWh in reply to Chris147]

Get a second opinion but get it from an EP.

[Hidden]

I am on 200mg Flecainide per day and my cardiologist won't admit to any side effects of the drug but I am aiming to reduce it after 2 years as I know there will be something, just hoping not too bad in the first 24 months - common sense?!

[howesgilly]

300mg flecainide is the daily maximum dose. I was advised that long term it isn't good for you byy ep and therefore happy for ablation and so far so good offends and awaiting if the pay return's or not.