Hi guys
Can anyone explain, a) what constitutes an ectopic heartbeat and b) Atrial Flutter? My reason for asking is after 16 episodes of AF within the first 3 weeks of cryo ablation I've had 5 days without AF excepting skipped heartbeats,some with a positive thump and today a 5 second burst of what seemed like start of AF, but possibly a flutter.
Without seeing an ECG trace it is hard to tell what is going on but I can explain ectopics.
Ectopic means out of place or position so an ectopic beat occurs out of sequence. If it is a ventricular ectopic the ventricle contracts early before the atrium has passed any blood down to it so has nothing to pump resulting a a "missed beat" feeling with usually a thump when it gets back into order.
Atrial flutter (easily seen on ECG as a saw tooth trace) is a fast regular beat.
It is often the case that ectopics come in bursts, doubles or bigeminy, tripples or higher multiples but ectopics are not AF and technically cannot become AF.
Firstly - 3 weeks is not very long after your ablation, so I think is too soon for you to be concerned
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secondly: Not medically trained! Also I do not know if you have any other co-morbitities. I did not and knew this when I had the ablation. I was 57 years old
However I had a cryoablation 23 months ago, which has been very successful not touched a drug since May 2018. (except a few paracetamol)
However I still get ectopics - they come and go, I did months without hardly noticing them and I do my damnedest to ignore them , for a large part successfully, but the last few months have been a challenge as I have had a few long runs, at one time was beginning to think afib was back.
Ectopics are extra beats . they can be Premature atrial contractions or Premature ventricle contractions (PACs and PVCs). Look it up on the web, lots of info.
I understand that they are mostly harmless but if you are worried speak to your EP. on my 12 months checkup mine was not worried at all, I was not really but I had been running 6 miles twice a week plus a 25-50 mile cycle ride by that point, so I felt fairly robust! The EP never asked to do any more tests either when I told him i got them and i described them.
I have what I class as 3 types of ectopics:-
(1) short bursts of fast lumpy beats that can be quite fast but last seconds - sounds like yours. I never bothered at all about those.They don't make me feel bad its just a bit weird.
(2) "missing" beats that give you a "fluttery" feeling in the higher chest lower neck. More worrying as I used to start AFIB like that , although I lost the flutters after a few seconds as my heart rate accelerated past 130BPM! A lot of time these ectopics last for minutes (5 to 20)then subside. I understand the flutter feeling is caused by the extra beat emptying the heart, so when the normal contraction occurs there is nothing to pump. If you feel your pulse there seems to be a gap (as not much blood was pumped), so you think you have missed a beat not gained one. Sometimes it works so the heart then fills up very well and you get a big thump following the "missing" one . you can find descriptions on the web. I don't bother about them if they stop in 20 mins, I don't let them interrupt me doing anything.
(3) similar to (2) but they last for hours but seem to be a bit less uncomfortable.
Until a couple of months ago my record was approx 10 hours, but the last few months have lasted days on some occasions. On two occasions I was about to go to hospital to try to get an ECG to see if that would shed any light and both times they stopped just before I went!. I do not think it is afib as my pulse is regular except for the "missing" beats. The "missing" is irregular: could be 3rd beat next 18th beat, next 33rd beat, then only 8 beats, then 50 beats, but in between the missed the heart beat is clockwork.
I found it very easy to ignore (1)s and (2)s, but (3)s grab your attention , and then of course you notice them all the more, and start to worry about them. Worry is the root of most heart evil in my view! So try not to!
AFIBBERS are heart sensitive - I can hear my HB if I try, when I had afib I found it difficult to not hear it. I believe I may have had ectopics all my life but never noticed until AFIB focussed my attention on it!
Of course having said all this, as you know if you have had afib, everyone is different !. Happy if anyone with similar experience can interpret what I have described in a different way.
You mention flutter - have you ever been diagnosed with flutter? - it is not the fluttery feeling!
Post AFIB cryablation I developed re-entrant atrial flutter (right atrium). That was not at all like what I believe are ectopics. My flutter was rate controlled by the diltiazem I was taking for the afib , at a fairly consistent 140BPM. Flutter is an irregular heart beat in a much as it is not normal and shows as an abnormal ECG with a sharkstooth pattern on the ecg trace, but it is regular and consistent in its beats (unlike afib).(mine was anyway).
Dr John Mandrola has a very good description of flutter on his web site - well worth a read.
drjohnm.org/2013/08/atrial-...
When I had AFIB I was asymptomatic even at very high HRs. I was running and my HR was 243 and I could not tell except my Garmin told me.( the garmin running watch was the only reason I found out I had afib). With flutter I could not walk to the kitchen without being breathless!
I hope this helps some but if you do get concerned or you get other symptoms speak to the medics.
Best wishes
Hi I had these signs when going to bed lasted for about 5 or 10 mins, cardio done ecg and said ectopic beats caused by pulse too slow about 40 bpm , so he said only take one 2.5 bisoprolol about 5 pm , after 2 weeks pulse back to 60bpm and ectopic s gone, but sometimes can hear or fell heartbeat in head when lying on a particular side in bed , hope u get sorted .
Are 16 episodes of AF over 3 weeks typical for you, or is this much greater frequency following the ablation? The fact that the AF is subsiding into ectopics *might* be a good sign that the heart is settling down.
Hi Samazeuilh these 16 episodes are far greater than what I experienced before ablation, which was averaging 1 a month. Having said that, apart from 3 episodes lasting 14,11 and 11 hours ALL other episodes have been, 7 under 10 minutes and 6 between 10 and 45 minutes.
Has the EP expressed a view on the significance of this?
Wont see the guy who did the job until 3rd March, and to book a docs appointment is next to impossible, so it's a waiting game
I would have though that a sudden upsurge in episodes of AF would warrant an urgent GP appointment- surely if you stressed that this is a new pattern they would respond?
You could also ring the EPs secretary and say something like “I am very concerned that as a result of the procedure which Mr X performed I am now experiencing new and frequent AF and must wait for two months before I see him.”
Its very much the responsibility of the hospital where you had the ablation to provide adequate aftercare; they don’t seem to be responding at the moment. If all else fails you could speak to the cardiac nurses at BHF, but I would be surprised if they do not recommend a prompt appointment with at least a GP.
Don't know if this is of much use but thought I'd post. I have the Kardia single lead EKG and app to go with. It shows me in real time whats going on when I do not feel well.
I suffer flutter when on an Electric Commuter Train when it pulls in/out of stations. I have been told it is to do with the intense EMF Fields that you sit in when onboard Electric trains if you are anywhere need the motors. Other wise I am getting better 9 months post ablation with only morning ectopics.
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