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Atrial flutter and fatigue

NorthLeedsJohnny profile image

Hi all. I had 2 x catheter ablations for multiple ectopics (thousands a day) last October. The second was successful. A few weeks ago, I had very severe dehydration, because of acute gastroenteritis. The end result of that is atrial flutter! I've been in hospital twice and am now waiting for a cardioversion, followed by another catheter ablation.

Since coming home, I've been extremely tired, especially in the afternoons and invariably fall asleep for quite some time each day. Is this to be expected? Any further info would be appreciated.

Thanks

Johnny

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BobD profile image
BobDVolunteer

Fatigue is normal. Your body thinks you are running a marathon .

NorthLeedsJohnny profile image
NorthLeedsJohnny in reply to BobD

Thanks for that. Presumably, it'll continue until the cardioversion.

millie-becca-187 profile image
millie-becca-187 in reply to BobD

This maybe a silly question to ask, and call me stupid but I'm going to ask it anyway.

If your body thinks you are running a marathon because your heart rate is so high, then how does this not affect your metabolism and therefore lose weight?

Ppiman profile image
Ppiman in reply to millie-becca-187

I think it's a way of describing only, not reality. In atrial flutter, at least, which I have, the top of the heart (the atria) isn't pumping at all, but is vibrating instead, regularly, at 300bpm. This achieves very little, I gather, and the result is that the bottom chambers (the ventricles) are left to do all the pumping work. But, they, too, aren't pumping normally and are forced to work in a ratio with the top 300 beat, being allowed to beat only at 50 / 75 / 100 / 150 bpm in an inefficient step-wise fashion.

I gather that the atrial problem leads to a 15% reduction in blood reaching the ventricles, and the unnatural ventricle beat itself then leads to a less efficient circulation overall. The net result, in my case of persistent flutter, is a disabling lack of stamina, combined with symptoms of a frightening feeling of shortness of breath, unpleasant chest / sternum / lower ribs sensations and mild pains that create a lot of fear. Yesterday was difficult for me but maybe I overdid it putting the bean fence up the day before! ;-)

Steve

NorthLeedsJohnny profile image
NorthLeedsJohnny in reply to Ppiman

Exactly my current situation! Thx.

Ppiman profile image
Ppiman in reply to NorthLeedsJohnny

You have my sympathies. Many people here have atrial fibrillation, and many say they cope well with it. Flutter, in my case, is disabling and truly awful.

Steve

NorthLeedsJohnny profile image
NorthLeedsJohnny in reply to Ppiman

I know exactly what you mean. At the moment, I'm waiting for cardioversion and ablation (yes both!) I need to wait, so that the Rivaroxaban thins my blood sufficiently, to reduce the risks during the procedures. I've been on them for 2 weeks now. However, in the last day, I've felt much more dizzy than before. Is that something I should be telling my doctor? Had it been just a side effect, I would have expected it to have kicked in before now.

NorthLeedsJohnny profile image
NorthLeedsJohnny in reply to NorthLeedsJohnny

I should have said too that my heart rate is being treated by Diltiazem.

Ppiman profile image
Ppiman in reply to NorthLeedsJohnny

Bad luck, eh, John? We’re suffering similarly, I think - and what suffering it is. Crumbs - my life has shrunk to be frightened of doing much at all.

4 weeks ago, after a second “event” of feeling faint and strangely ill while going up some stairs, I spent the night in hospital, was told I had permanent atrial flutter, left a day later on rivaroxaban (20mg) and bisoprolol (now at 7.5mg). My heart rate still kept going too high (100-150) until I was given digoxin (125mcg), now it’s 75 mostly.

Your symptoms seem the same as mine so far as I can tell. Mine are; light-headedness (especially when standing up, and badly from a crouching position), some mild chest pain (all day yesterday)- along sternum and under left rib cage, slight breathlessness, a general really very unwell feeling, sometimes very frightening and with little stamina.

I’ve got an ablation planned for Sunday if my cold improves sufficiently.

The specialist did think of also doing cardioversion but hoped the digoxin would tide me over, which it has so far.

Steve

Ppiman profile image
Ppiman in reply to NorthLeedsJohnny

I've just spoken to my cardiologist to confirm things for next Sunday. As long as my cold keeps improving the ablation should go ahead.

I asked him why flutter symptoms were so bad. He said it was the regular beat of the top of the heart that caused this as it forces the bottom of the heart to act differently from in fibrillation, and it is this that reduces the efficiency of the circulation and creates a whole range of persistent, unpleasant and often frightening symptoms.

On the upside, flutter is, apparently, the easiest, safest and most successful to treat with ablation.

Steve

millie-becca-187 profile image
millie-becca-187 in reply to Ppiman

Thank you, that's a great explanation. I understand a lot more now.

NorthLeedsJohnny profile image
NorthLeedsJohnny in reply to millie-becca-187

Me too!

Ppiman profile image
Ppiman in reply to millie-becca-187

Do you, too, have permanent atrial flutter, Millie? It must be a lot less common than fibrillation and I've found it quite hard to find much useful information about it - most on the Internet is from people with fibrillation.

Steve

NorthLeedsJohnny profile image
NorthLeedsJohnny in reply to Ppiman

I've no idea whether mine us permanent. I guess I won't know that until I've had both procedures. My symptoms are much like yours Steve, except for the chest pain. I get palpatations all the time but not pain as such. Initially, when this all arose a few weeks ago, it was very severe chest pain and a heart rate of 200 which had me in hospital. However, the doctors there have told me that I shouldn't get that pain again, as it needs both flutter and a high heart rate. The Diltiazem has brought the rate down a lot.

Ppiman profile image
Ppiman in reply to NorthLeedsJohnny

Hi John

That must have been frightening, to put it mildly. I didn't get any pain initially - well, a bit along the sternum. All doctors have told me it is normal and to try not to worry. You can tell that you have flutter all the time if you cannot do normal stuff, I'd say, and if you heart rate doesn't gradually increase in response to exercise but goes up and down in a step-wise manner, say, 75 > 100 > 150 (or thereabouts).It's the presence of the flutter at the top of the heart that stops the normal gradual rise and fall of the rate and forces the stepping to happen.

What I find is that at ~100 I start to feel not brilliant, but that at ~150, I soon feel unwell and need to rest. The digoxin brought me down to ~75 and that has helped a bit but overall, as I say - this has really knocked me for six.

Steve

NorthLeedsJohnny profile image
NorthLeedsJohnny in reply to Ppiman

Thanks for that Steve. I have a garmin fitness tracker which my cardiologist tells me is surprisingly accurate. I have to say that I've never noticed the heart rate rising or falling in steps. It does rise and fall but not is such a regimented fashion. That said, when in hospital, the doctors told me that my ECGs show clear evidence of flutter. Its all a bit of a mystery to me!

Ppiman profile image
Ppiman in reply to NorthLeedsJohnny

Hmm - not sure on that one but there are often mixed things going on, I gather. For instance, I've been told I have a secondary 'conduction' issue called left-bundle heart block that they hope might resolve on its own when the flutter is sorted (fingers crossed).

Oh to be young again, I say! ;-)

Steve

ETHEL103 profile image
ETHEL103 in reply to Ppiman

Hi Steve has flutter caused any strange buzzing sensations around left ribs. This kept me awake most of last night and it's still going on. Pulse seems normal and I did note my stomach was making some noises too. Doc told me to stop lansoperazole last week. Wonder if this is reflux.

Ppiman profile image
Ppiman in reply to ETHEL103

Stopping lansoprazole can be difficult as I found before giving up and carrying on with it. It’s said to cause “rebound reflux” and it does. Big time.

The feeling in the left ribs you describe is common with me. In fact I’ve had it since just before Christmas this time along with all kinds of other issues including fast heart rate and chest “aches” and stitch-like feelings. I’m having some tests and I think it’ll turn out to be hiatus hernia related or reflux, rather than my heart. I bet yours is that or similar, too. The strange sensations can travel into my back at times.

Steve

ETHEL103 profile image
ETHEL103 in reply to Ppiman

Interesting thankyou. Saw a private cardio last week and mentioned it to him, of course it was t happening when I was in his office but he said it was unlikely to be cardiac related. Am I right in thinking you are still on Lansoperzole then?

Ppiman profile image
Ppiman in reply to ETHEL103

Oh yes. I tried hard to come off it for some months, trying other things like ranitidine but to no avail. I’d read this and that about “PPI” drugs but my GP felt it was best to stick with it since reflux itself can be dangerous long term.

I find cardiologists don’t want to look beyond the heart.

Steve

Are you taking a beta blocker?

NorthLeedsJohnny profile image
NorthLeedsJohnny in reply to

No. I've just been prescribed Diltiazem for my heart rate, which was initially 170 awake and 120 resting (usually 55 for me) and Rivaroxaban to thin my blood.

in reply to NorthLeedsJohnny

I would speak to your EP/Rhythm team/GP to express your concerns. It may just because you are running a marathon (what is your HR now?)

NorthLeedsJohnny profile image
NorthLeedsJohnny in reply to

Thx. I'll do that. Just now it's 80 laid down

NorthLeedsJohnny profile image
NorthLeedsJohnny in reply to NorthLeedsJohnny

It has occasionally dropped to 45. I told the GP but she told me not to change any medication.

Sounds perfectly normal to me, at least for a good few weeks.

At least, it was for me after 22 DC cardioversions. Though after one of them I was awake for 28 hours post-cardioversion because my daughter was born. That was nearly 2 years ago and I think I've been tired ever since.

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