Ok so my single flutter was 150 beats in early April. 24 hours...nothing since. The Electro guy saw me in July and put his stethoscope on my chest and said to his assistant "Flutter... atypical left atrium":...She enter it on my record. I then wore a 24/7 monitor for 1 month. They called yesterday and said the monitor showed no events and I could cease Eliquis. Question.: If I was running at 64 beats with no events in July, how could the EP detect a flutter at the July exam, AND if there is an ongoing flutter that is detectable with only a stethoscope, and doesn't speed up my heart, how come I am being taken off eliquis ? Funny how these question only come to mind after...
Futter with no event ..How can you de... - Atrial Fibrillati...
Futter with no event ..How can you detect with only a stethoscope ?
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allserene
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It sounds like your flutter may come and go, so you had it when you saw your EP, but not when you had your monitor on. It doesn't sound right to be taking you off your Eliquis as you could go into flutter again at any time. I would talk to your EP if you can and explain your concern, even if you can only make contact via his secretary.
Jean
I monitor my heart rate ever day and I am always around 63 beats (with 2x25mg betas). ... So is it possible to have an atrial flutter going on, but no fast pulse ? .... In other words a fluttering atrium that is firing of itself, but does NOT cause the ventricle to fire and shows a regular 63 pulse ? That would account for the EP being able to detect a flutter that is not causing palpitations or a fast heart (ventricles) .... That would mean there was a danger of blood pooling in the atrium.....and I guess that is what is called silent flutter that is not registering /detectable by the patient or the blood pressure monitor... Yes I am seeing the nurse/practitioner next month so I will try and get a handle on a flutter that is detectable only with a stethoscope, but nothing is happening in consequence (apart from possible pooling)
Personally I can't see how an electrical malfunction CAN be detected with a stethoscope ! It normally needs an ecg to see what is doing what.
Me neither..... I marveled at his verdict at the time.... I thought wow this guy his good to be able to do it with a stethoscope ..Going to call them right now...will report back
Ok Bob made the call ...told her the story... She thinks I got it wrong and when he was saying "atrial flutter atypical, left atria"; he wasn't speaking about his his stethoscope findings to his assistant, but rather he was look at the screen from behind me, and reading out what the hospital had found in early April.... He then considered the full month monitor results ...totally clear, plus the length of time from early april, and my daily pulse monitoring on my THREE bp/heart rate machines (lol) and decided I didn't need to continue eliquis any more.. Eliquis is $640 a month and $280 a month on medicare insurance, and $80 a month from somewhere north of Wisconsin... Ok mystery solved ! I have 2 months supply of Eliquis, so if I go into flutter again I will start popping em immediately (they are fast acting) plus double dose of betas..(50 mg), and that should 'convert me' within 12 hours or so...
it's possible to have a stroke after 6 minutes of AF ( not flutter- don't have the figures for that, sorry) so be very careful about stopping anti-coagulants. Check your Chads Vasc score for stroke risk too( AF website)
If flutter = a stroke after 5 mins, and my flutter might return say once in every 7 years for 2 hours, then that would mean anti-coag for life to cover a pretty remote risk which is quite onerous, and the risk is only 'increased risk' and not a certainty........... My chads score is low as my heath has always been good (apart from Multiple Sclerosis, malignant prostate cancer, atrial flutter lol) I seem to have dodged them all and I am working hard in the yard loading topsoil and not getting faint/out of breath etc... Quite a decision, but taking a pill for life can be quite dangerous too I reckon..... Its a quandry
Hi All serene,
That was the stroke risk for AF You'd need to research timing for flutter and stroke. However, as your left atrium is involved, and as AF and flutter often co-exist /trigger each other after one is dealt with, you need to be cautious.
You can't say flutter will only come once in 7 years unfortunately- what you could do is wait longer than the few months you have mentioned before making a decision to stop anti-coagulation. There is something called HASBLED which you can use to work out your bleeding risk but most of us here have not had bleeding problems- although you are right there are risks.
What is your chads vasc score? and what age are you?
I am 71 but very fit with no history of DVT etc... a chads 1 through age alone ......I go on the roof to sweep my own chimney and I have had a colonoscopy last month and banged my head in the garage causing a deep cut and a lump.....no sign of excess bleeding... I go on arduous foreign trips with much driving and jet lag... I want to live to 89 which is one more cat. Perhaps I am a 'one and done' for flutter....
be cautious then as all us 70 somethings have a more fibrous heart lining than the smooth lining of the young!
If you look at the NICE graphs for stroke risk with AF with a score of 1 you will find that it is quite low . This is for having a stroke at all and gives no indication of length of time in AF before the stroke manifests. If your EP thinks you do not need Eliquis I would trust his judgement. You could always play safe by including naturally anticogulant supplements . Although there is no "medical evidence " for these there are Japanese studies on the efficacy of nattokinase. Also the fact that traditionally the Japanese had a greater tendency to haemorrhagic strokes rather than ischaemic strokes indicates that there was something about their diet that "thinned" their blood. This tendency has lessened with a change to a more western diet.
That sounds good. I will check those out... When I was looking a statins, they reckon they reduce heart attack risks, but the difference was like (fake example) 24% to 21% and you cant just stop and start them as the rebound risk is considerable.. Fact is that for folks in their 70s, their next new car is their last one, and so is their next kitten... Depressing if we think about it, so let's not... lol .. I categorize those thoughts with 'lost loves' and quickly change the subject in my mind by doing some lawn weeding... Bad enough being 71 without being down about it ...
Statins have very few if any positive effects on the elderly particularly women. They are a scam . I would never take them. Read Dr Malcolm Kendrick's blog . He has lots of interesting stuff on heart disease . My husband is 75 and still plays squash . I am 67 and though in daily pain due to widespread tendonitis can still enjoy short hols on our motorbike. Our much loved cat ( 11) will not have a successor if he does not see us out!
Same as us ..I am 71 and my wife is 60...I am strong with stamina and she has bad sciatica for 2 years plus, and limps around with ice packs on her left knee.. She sleeps with 2 pillows under her back...constant pain.. Seems life doesn't go as predicted by the overall statistics and everyone is different... I have had a specialist sending me a letter to say I have Multiple sclerosis..That was in 1998 and I thought I was dead. In the 21 years since them I have two small episodes... One of numb skin on my chest (2000) for 3 months....and one of burning scalp skin (6 weeks) ... 2016 election night USA... I have had a letter to say I have Malignant prostate cancer...Got it zapped with Cybernife and now my PSA is less than the average 17 year old...... 0.4... Now the atrial flutter which I can't claim to have conquered yet, but is absent since 1 incident in april... So I guess I have dodged 3 bullets so far....... Evidence suggests we wont get out of this life alive...
natural anticoagulants have the disadvantage that you can't measure the level of protection you are getting. Having looked after stroke victims when I worked in the NHS I wouldn't play with fire!!
That is also true to some degree with the "one size fits all" prescribing of NOACs. My ex GP's husband in England developed a pulmonary embolism on Apixaban ( that his NHS doc had prescribed ). He went to see a haematologist privately who switched him to warfarin and said that if one stayed at the correct INR level it was easier to monitor whether one was taking the right amount. When Pradaxa was first introduced there were many cases of old people having major bleeds some fatal due to overdosing.There is very little attention paid in any drug therapies to the differences between individuals in drug metabolism. It has been shown recently that the different physiology of women leads to them metabolising certain drugs differently than men and that the standard doses recommended lead in fact to overdosing for women. There is no attention paid to whether peopke have fast or slow liver metabolism though I have read that this can be tested for genetically.
Quote 'It is possible to have a stroke after 6 minutes of AF' I've been reading on here for a long time now, and I've never heard a statistic like this before. Please would you tell us where you get it from?
yes, from the Consultant Cardiologist ( clinical lead at Epsom St Helier Hospital) when addressing our patient support group. He has a very good blog if you'd like to read more things he has said about AF Google Dr Richard Bogle. Other speakers have confirmed this too when talking to our group.
Obviously allserene's EP is not of the same opinion. Quite frankly you could make this 6 min possibility an argument for putting everybody over 65 on an anticoagulant as they might then have a stroke within 6 min of their very first afib attack.
Not a very valid argument!! People who have already had AF are much more likely to have a subsequent episode. Let people decide on the facts rather than encouraging risk taking re stroke. Evidence based efficiency is vital.
And does not the "evidence based efficiency " say that a person with a CHADS2VASC score of 1 does not automatically get put on an anticoagulant especially if that score is for age not for comorbities?
Yes and, from memory, it says’ consider ‘ which means look at that individual’s risk factors- ie all their health factors - which is why we each must take responsibility for our own decisions. The fact that the score fir age doubles when one reaches 75 speaks fir itself I think. Tissue of all sorts ages and this includes heart tissue. I once asked why young people are not st risk of stroke with AF and the consultant explained it’s the rough surfaces of older people that allow clot formation when the blood is pooling in AF because if weak heart pumping action. So age is a big factor fir individuals to consider. Personal choice I think but be aware of effects of a bad stroke
I am pretty sure my "palpitations" had been going for more than a week before I went to the doctor and asked for an EKG.. Then he said I had a 150 bpm flutter and go to emergency... Looking back, I reckon the 150 heart rate had been going for 10 days before I sought medical attention... So I too would need to have verification of the idea there is a 5 minute window before the stroke risk become pronounced... At the first sign of a another fast rate, I would go back on my saved eliquis and be protected within a few hours as it is very fast acting
The effect is good after a few hours but if there wasn’t the risk I have described we would all be prescribed it as pill in the pocket. The health service would save a lot of money! However there is risk as soon as AF starts so we need to take them all the time. I’ve seen brain scans if a man who had a stroke after forgetting just one dose of hisAC. You must decide fir yourself but don’t influence others who may go on to have strokes
I am sure neither you nor I want to be seen as influencers either way. However, as with matters of religion, that is no reason why we should not express our own thinking publicly... Our own thinking on every subject is personal to us, but there is no reason why it should be kept private. I take your point that a person who needs to be anti-coagulated should take them all the time rather than 'as required', but having been advised by an EP who works at the forefront of this science, I feel content to drop the Eliquis for now, in the knowledge that I have a supply on hand, and I can be protected in a matter of hours if I have my second episode of tachycardia when I am traveling overseas or, say, on a Saturday evening at 8pm... My first and only episode lasted 10 days at 150bpm and no medication.
It’s your personal decision but anti Coagulation is not pip. That was a very long tachy episode / I’m on the ambulatory care unit st present having had an episode of tachycardia this morning which changed into Af
Treponin levels are up so they are checking for heart attack. Treponin can be raised with tachycardia too do always needs looking into and meds to reduce rates. Don’t leave fir 10 days next time !
I ask myself "should a person who has had one episode of tachycardia, stay on anticoagulants for life ? "..... I am 71 and I will live to 99, so 28 years sounds a long time on apixaban.... I also ponder what event would cause a person to justifiably cease anti-coagulants ? apart from death that is..
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