Advice needed for atrial flutter

[Happywalker]

Hi I posted sometime ago about my slow heart rate and have since had my bisoprolol dose reduced from 5 mg to 3.75 mg. My heart rate has increased from the 40's to the 50's and I have felt better. I have not been aware of any AF episodes but have what I think is AFl episodes at night. These episodes occurred before the reduction in the bisoprolol dose. I wake with this uncomfortable fluttering sensation in my heart. I then sit up and breathe deeply and goes away. I then feel a vague ache in my chest. I have resorted to sleeping propped up as it seems to occur more frequently when I sleep flat. However over the last few weeks I have noticed that it is occurring more frequently and lasting longer. I am not getting a good sleep and it is making me anxious. How do I know that it is actually atrial flutter? I haven't been back to my GP as I thought I would get some advice from this forum first. Should I go back to taking 5 mg bisoprolol? It would mean going back to a heart rate in the 40's which does not make me feel well. Do beta blockers control the incidence of AFl? Can I ignore the AFl episodes? I am on Warfarin. I am not aware of any AFl episodes during the day. I am beginning to wonder if I have sleep apnea as I have occasionally woken up with a snort. As far as I know I don't snore - no-one has ever complained. I am thinking that maybe holding my breath while sleeping is setting off the AFl (if that is what it is?). Advice needed please.

[jeanjeannie50]

Have you checked your heart rate when you're experiencing atrial flutter? You should notice a faster, but even pulse. I've had it in the past, but not been aware of any fluttering feeling in my chest.

As you recover quite quickly when you wake up and are aware of yourself snorting, I think the sleep apnea sounds more likely. Have a word with your GP to see what he thinks and ask if you can have a test to confirm.

[Happywalker in reply to jeanjeannie50]

Thanks for your reply. I haven't managed to check my pulse rate while experiencing the fluttering but will try to do so the next time. So far I have just been concentrating on the deep breathing to stop it. My pulse is normal once it has stopped.

[TinCool]

If you have a smart phone I recommend you download an app called SnoreLab. You place your phone on your bedside face down and it records any snoring events. You can then play back your nights sleep as such through a graph where it's picked up sounds. I must say it's quite an eye opener.

I have been using it the past few nights to record my nights sleep as my wife is convinced that I have sleep apnea. Which is plausible since the 3 crazy AF events I have had always occur whilst in bed just as I wake in the morning. The app isn't going to pick up sleep apnea but if you are associating it with a snort then this app may pick up on that.

[Happywalker in reply to TinCool]

Thanks. Interesting app. I will give it a try.

[Hidden]

Perhaps ask your GP about sleep apnoea and separately hiatus hernia.

Beta blockers don't generally prevent AF/AFL but usually slow the rate during the episode. Extended holter monitoring may pick up any nocturnal AF/AFL.

[Happywalker]

Thanks. I will research a hiatus hernia. I probably do have a slight one and am careful not to eat a large meal in the evening or to eat too late or I get painful indigestion which can be mistaken for heart pain.

[Doddsey-UK]

HiYou sound like me. I did go to the doctor as my heart rate was going as low as 30. I was only in 2.5mg bisoprolol which the GP reduced to half but then I had 22 notifications that my heart was racing as Hugh as 176 when resting. I was referred back to EP mainly as I wanted to find a suitable medication to control heart rate. I was hoping to wear a holster monitor for 7 days to monitor heart rate but he has advised a repeat ablation. Now I’m concerned do I really need it as most of my episodes are happening at night. I too wonder about sleep apnoea as I have woken up in a state of panic. Now I feel between the devil and the deep blue. Do I have the ablation or not? Sometimes I wonder if I’m imagining it but mostly not. Difficult isn’t it.

Lindsay

[Happywalker in reply to Doddsey-UK]

Very difficult. I think I would feel just like you about having an ablation. I have decided to ignore my flutters as they are short lived and get some sleep. I don't want to go back to a low heart rate as I did not feel well. Hope you can resolve your dilemma.