Has anyone been treated successfully for atrial flutter? I awoke yesterday morning with a pulse of 90 (my heart rate is typically 60s-70s). I've gotten used to the occasional episodes of afib and atypical flutter which usually resolve in a couple of days. But this was different. No matter what I did (relaxing, extra metoprolol and my usual dose of flecainide) nothing changed the rate - it stayed between 88-92. I spoke with my EPs nurse today who said that atrial flutter will frequently lock in at a certain rate and that it's very resistive to metoprolol and flecainide. Since it was a Friday afternoon, I won't hear back from the doctor until Monday. She said he will probably recommend a cardioversion. I'm not a fan of cardioversion - had one and the afib returned rather quickly. I'm wondering if anyone has found a treatment that works.
Treatment for Atrial Flutter - Atrial Fibrillati...
Treatment for Atrial Flutter
I had atrial flutter 2 years ago - 150bpm for three days so was hospitalised and had a cardioversion. That lasted a couple of months then I went back into AFlutter then my first episodes of Atrial Fibrillation. I had an ablation that fixed the flutter but not the AF, then another ablation fixed the AF too. I’ve been pretty good since then (18 months).
Good to know - thank you.
I had an ablation last June for atrial flutter that was resistant to bisoprolol. That said, when I was given digoxin, that did lower my heart rate but I was feeling pretty terrible all round, nonetheless. I was very grateful for the operation, which, apart from one bout of fibrillation a week or so after it, and continuing ectopic beats (palpitations) has proved a success, so far.
With atrial flutter, I’m told, the heart rate is most often a fixed ratio / fraction of the speed that your atria are beating (or “fluttering”) at, which is around 300bpm. So you might have, for example, 1/2, 1/3, 1/4 of this as your pulse (in your case, 1/3).
Steve
Although I said I wouldn't have another ablation, it looks like that might be the way to go. Thank you for your response.
I feel for you, Judy. It’s not the tachycardia that is likely your problem but the way flutter makes you feel. In my case I was truly debilitated.
If the fibrillation I suffered a week after my flutter op last year had continued, I was told I might well have to have had a second ablation; at the time, I was down for an emergency cardioversion, but, thankfully 5mg bisoprolol returned me to NSR within an hour or so.
I gather, as Bob says, that the procedure for atrial flutter is altogether much easier and safer for the EP to do. This is because that arrhythmia usually occurs in the right atrium where the catheter arrives from the leg vein - and the success rate is close to 100%.
Steve
100% sounds good to me! I'll be anxious to see what the EP says on Monday. One good thing about having a pacemaker is that I can send a transmission and they'll be able to see exactly what's going on so he should have some options ready for me.
Best of luck with your consultation. At least you'll be well armed with solid information from this site! 
Steve
Hi, I have Atrial Flutter and have had Bisoporol increased three times in nine months, from 1.25 to now 10. Would you agree that I am in the "resistant to Bisoprolol" category.
Should I now push for ablation?
Thank you in advance
I've never heard of resistance to beta-blockers. When I had persistent atrial flutter, before my ablation last June, bisoprolol alone did little but reduce my blood pressure too far. After some advice from a member here, I was changed to a combination of bisoprolol and digoxin and, lo and behold, this worked to keep my heart rate down and my blood pressure at a more normal level. Previous to using the digoxin, I had been moved up to 10mg of bisoprolol; with the digoxin, if I recall, I could drop this to 2.5mg or even 1.25mg. Even so, I felt awful, but, how much of that feeling was down to anxiety (aka "fear") and how much to the arrhythmia (or to the tachycardia), I'll never know.
Recently, however, I've had a new bout of tachycardia and I've been back on a tiny dose of bisoprolol this last week. All seems well so far but I have a 24-hour ECG planned.
Steve
Atrial flutter is easliy treated by ablation. That said any rate below 100 is not generally considered a problem.
Have been treated by ablation 7 years ago which helped a lot .
Hi! Yes I had Atrial flutter and AF - often went in and out of them both in A&E. cardiologist decided to ablate the flutter as the AF was sorted pretty easily with Flecainide. Successful
Flutter Ablation 2 years ago and had neither flutter or AF since (fingers crossed) Good luck
I was first diagnosed with AF and cardioverted successfully. I had another episode 2 years later which was diagnosed as AF and cardioverted with Flecainide. I was given flecainide as a PIP but during a later episode the PIP had no effect. When I went to the EP I was then diagnosed with Flutter. I was offered an ablation for both AF and flutter but elected to have just the flutter treated.
I have been in NSR now for over 2 years. 🤞
Are you still on flecainide? I've been reading that it can cause flutter so I'm wondering if I should stay on it if I'm offered an ablation for flutter.
I am on no meds whatsoever following my last ablation 2 years ago
Good to know - thanks.
No I’ve not needed it. I do have it as a PIP but that’s more as a security for me than a need.
Yep, I had an ablation 3.5 years ago for fib and flutter, nsr since
Thank you - good information.
I do not have this but on my pre-ablation talks back in February I met a person who had been successfully treated with ablation for Atrial Flutter and 10 years later he is still fine.
That gives me some hope. Based on the comments I've received, I'm leaning towards an ablation. Thank you.
I had an ablation for atrial flutter last April, when I was going in and out of AF and Flutter, and though I had episodes of AF several times afterwards, no flutter, and the AF has gone as well, at least for the time being, so good luck!
Thank you. I hope you continue to feel well.
I forgot to write that I was taken off Flecainide on the day of my ablation.
Thanks for your reply.
They did not do an AF ablation(PVI-- pulmonary vein ablation) to take you off the meds altogether which was Amiodarone pre ablation and is Flecainide post ablation for you, but instead did atrial flutter ablation only (CTI -cavotriscupid isthmus ablation for typical flutter in the right atrium with 95% ablation success in most lilterature). -- I believe I got that right.
I don't understand. I thought the purpose of ablation (without symptoms discussion) was to be free of arrhythmia and drugs ( if possible) not to live with arrhythmia and meds. I haven't heard of a purpose of an ablation merely to be to switch drugs to still keep you in arrhythmia.
Am I missing something? What stage of AF are you in? Also, if you have had a CTI ablation and you take Flecainide only, the typical flutter won't come back? What about developing atypical flutter like perimitral flutter (PMFL)?
So since the 2014 ablation for atrial flutter, you still have paroxysmal AF which is being treated with Flecainide? Or, since it's 2020, are you in permanent AF?
I'm still missing something. Why wouldn't the EP also do AF ablation along with atrial flutter ablation? I had both at the same time for the third ablation, and now I have been almost a year and a half in sinus.
For my first ablation which was very long, my heart swelled, so the superior right pulmonary vein couldn't be totally ablated, so I had to have a second ablation to finish the job.
I couldn't find any literature substantiating your statement " it's very resistive to metoprolol and flecainide. " When I was diagnosed with atrial flutter, my GP prescribed metoprolol. Is your EP nurse saying it was the wrong med?
I don't really know. I just know that taking both meds wasn't helping me at all. I hope to ask the doctor about it when I talk to him tomorrow.
My flutter ablation took alot longer than 30 mins, more like 2 hours and I was awake the whole time. Not a pleasant experience.
My experience of atrial flutter was a pulse of about 120 BPM but atrium was fluttering at 400. Felt good for nothing. Was out on bisoporal but caused breathing problems. I'm asthmatic. June 2019 had a cardio version and have been in normal sinus rhythm ever since, touch wood. Still taking apixaban for some reason.
It's good to know that a cardioversion worked for you. I might opt for one if I'm given a choice of treatments.
If it hadn't worked I would then have been offered an ablation apparently. Good luck with whatever treatment you decide upon.
I am so, so sorry to hear your story. I felt something was amiss when only one arrhythmia was ablated. If you have the money, and since you are so close, I would suggest Bordeaux, France. That's where I went when my experience in Canada was unsatisfactory. I am now in sinus rhythm.
It sounds as if you area close to persistent which you want to avoid lest you need to have several ablations, which by the sounds of it they won't offer you if they wouldn't address your fingers in a timely manner. Can you not go to another hospital?
I have heard that cancer also has a limited time for early diagnosis.
You have a lot on your plate. I do wish you the very best.
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