Atrial flutter back after 2 years

[Poluneeru]

Hi

I had an atrial flutter with HR of 160 this morning at 9;00 am. EMS came and took me to Duke emergency. They gave5 mg of metoprolotiv but it didn’t help much . Now they gave 25 mg of long acting metoprolol which didn’t help much so they gave 30 mg of Diltiazam and Hr is now at 65-70 . But every time I stand or walk it goes to 150. I am under observation for the next few hours int they figure out what is the next step

Has anyone taken Diltiazam . Need some thoughts and what side effects . This is the first time I took Diltiazam

Hopefully my HR settles and they send me home 🏡

Thanks

Padma

[Kaz747]

Any talk of a cardioversion? When I had a 48 hour episode of AFlutter that meds wouldn’t budge, they tried a chemical cardioversion (drugs via IV) and when that didn’t work they shocked me.

[Poluneeru in reply to Kaz747]

I asked about cardioversion but they have not decided yet

Long acting metoprolol and Diltiazam worked . Now I have NSR . Hopefully it stays that way

Has anyone been on. Diltiazam. If so can you please tell me any long term side effects. It looks like they are planning to put me on metoprolol and diltiazam

[Rubymurray25]

Good that you are in the right place to be monitored properly and I am sure they will get to the bottom of it, you might just have to be patient as from experience they don’t like rushing the tests. Good luck hope all goes well. Must have been a shock after two years! Kind regards.

[CaroleF]

I have been taking Diltiazem (240mg once a day) for just over a year. What I believe is called the 'loading dose' (what you take initially) was lower, but I don't now recall what that was - maybe 80mg??

This has worked much better than bisoprolol (which I didn't get on with at all) at reducing my HR and lowering my BP. The consultant warned me that side effects might include swelling of the ankles and feet and constipation. Happily for me neither of those things has happened. However, we all react differently to drugs and I know that others here have not got on with Diltiazem. I'm afraid it's a matter of trial and error.

I was told by the hospital dispensing pharmacist to take it at night which is what I do - at bedtime - and I think that is because it's a slow-release medication.

I hope you find that it suits you.

[KMRobbo]

I took it for 10 months for afib. Not great but for me better than beta blockers bisoprolol or Atenolol.

I was on 200mg per day and I am sure I was overprescribed. I did try 120mg for a short after getting the dose reduced.unfortunately I missed a dose of flecainide that I was on for rhythm control and went back into afib, so they put me back to 200mg. Theory was i was less liely to go back to hospital on the high dose . I was waiting for an ablation so I put up with it. I would not a second time.

The side effects were brain fog, a worse memory, a bit of breathlessness and exercise intolerance. Max hr 137 ish when running and that was agony to maintain: like the last 100 metres sprint on a mile race, - although I was only doing 7mph!

The 120mg tablets were another 10- 22 bpm on my hrmax running so I could run not much faster but a lot easier. The brain fog was less. I think I could have managed with less than 120mg, at which level I may not have had any adverse symptoms.

Of course this is my experience- yours may not be so bad, and you are on a smaller dose! So I would not worry until you know you have issues .

When you say your flutter is back after 2 years, did you have an ablation 2 years ago for it? I am interested as I got re entrant flutter 9 days after my a fib cryo ablation and had to have a second ablation for the flutter. I was given the impression that it was unlikely I would ever need a second one for flutter.

Best wishes

[Poluneeru in reply to KMRobbo]

Yes I had my second ablation 2 years back. It was successful and I was off all meds . I felt relieved and different but I knew that it will come back but never want to believe it . I know it is one thing I cannot control . I am meeting my EP in the next coming weeks to see what my options are now.