AF Association
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How do you know if you're in flutter?

Had a nasty cough and cold over new year which seems to gave cleared up but since Monday I haven't felt right, feeling like my heart is racing on and off and also a bit breathless and light headed. I felt like that when I was in flutter last year and my cardiac nurse is advising I go to a&e but I hate the thought of sitting there all night to be told my ecg is normal so how do you all know?

7 Replies
oldestnewest

Really the only way you would know for sure is by having an ECG which would show the familiar saw tooth waves indicative of A flutter. You could be having bouts of atrial tachycardia .

I would take your cardiac nurses advice.

Sandra

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I am recovering from head-cold and my rate and rhythm is all over the place - virus does affect it. I have recorded a few episodes of tachycardia and AFl during that time but it doesn’t bother me - I wouldn’t want to be sitting in A&E either!

If you went I’m not sure what they would do but take an ECG and reassure you if it was OK - good news surely - if it was AFL monitor you and send a copy would to your GP - so again good news as you would have proof. I think it has to be a personal choice, unless you feel very ill or have chest pain.

I am just giving myself time to recover, plenty of rest, hydration and slow breathing. Rate seems to jump when I move about too much so I am pacing myself carefully.

I know when in AF /AFL because I monitor my rate/rhythm on Kardia - as Sandra says - looks like classic saw tooth.

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Becky

Classic atrial flutter is characterised by regular irregularities, as opposed to atrial fibrillation which is irregularly irregular, unless highly organised.

The atrial rate is typically 300, the AV node will regulate this generally to factors of 300. So 150,100,75 and 60. 2:1 block, 3:1 etc

One problem that can arise is mistaking 5:1 block at 60bpm and completely regular, for NSR. I referred to this yesterday in my SmartyPants OP.

Sawtooth pattern classically but only if atria are normal. See p-mitrale and p- pulmonale. Cardiac fibrosis and open heart surgery as for your CHD can also impact the p wave. Or you may have no p waves at all evident on routine ECG or KARDIA. Echo always identifies flutter if present as it does fibrillation.

If you don't already have a Kardia, I recommend one. Even without sawtooth, typical regular rhythm / rate changes of flutter will be evident, as long as not mixed with AFib. Sustained symptomatic flutter is most often around 150 and sometimes difficult to distinguish from SVTs of various kinds, even occasionally for Cardios.

I know you had problems with Warfarin, and if you are still on it rather than a DOAC, perhaps consider home monitoring. Coagucheck allows of precise control of INR, and self adjusting ultimately, if GP happy. Particularly useful when Warfarin is impacted by intercurrent infection, temporary meds like antibiotics and dose changes of existing meds.

Tha'art nobbut a lass and tha'll be reet chuffed in nur time, as they say in these parts of the East Riding.

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Thanks for all your replies, I'm going to head down to a&e today I'm struggling this morning so better to be safe than sorry. My cardiac nurse said that if I'm in flutter I'll be admitted and cardioverted again, the flutter did me more damage than anticipated last year so I know it's not worth taking the chance I'm just not 100% sure that I'm actually in flutter. I think I'll definitely have to invest in a machine to check things myself at home.

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In the past when I've been in flutter I've been cardioverted....when meds have failed ( which is the norm for me )

Sandra

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If you have an I phone you can get an app called heart beat, so you can monitor exactly what your heart is doing

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Any weird sensations that might be flutter or AF and I check my Kardia - in my experience has been well worth having it for either reassurance or confirmation of need to take PIPs.

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