Stent Fitted LAD Blocked + Atrial Flutter Diagnosed

[Lagun68]

Hi all - this is a copy of a post I put onto the BHF site a few days ago but haven't received a response so far. The emphasis so far is very much about the HA/Stent recovery and not much about the Atrial Flutter side of things although some of the meds I am taking particularly Bisoprolol/Apixaban are for Flutter I understand. Would be grateful for any advice from the AF community of anybody who has had a similar duel diagnosis and if not any general advice on Flutter would be welcome.

Thanks

Hi folks I am a newbie here. As you can see from the title I have recently had a procedure (23 Oct) and am at home recovering. Have to say the cocktail of meds (7) is making me very tired and together with bouts of anxiety - which I have a history of - is not helping at all. I am awaiting to start cardio rehab which owing to covid will not be face to face but have an initial tel. appt next week. At this early stage I am still finding my way but would be interested to know if anyone out there has had the 2 for 1 that I have had i.e. Angioplasty (1 stent) and Atrial Flutter and how they have got on. I should say that prior to this I have had episodes of fast heart rate for some time and was awaiting to see cardiologist for a definite diagnosis but was overtaken by events. I am therefore aware of the AF site but thought it appropriate to post here first. Thanks.

[Paulbounce]

Hi Lagun.

First of all welcome to the forum.

OK - I don't know enough about this to comment. However I'll take a punt and say other forum members will. I feel sure that you'll have further comments soon that will be able to offer more help than I.

Just a quick post to acknowledge yours. It can take a few hours or more for people to respond as they log in.

Good luck anyway.

Paul

[Lagun68 in reply to Paulbounce]

Paul thanks very much for your early response.

[Buffafly]

There are probably quite a few people who have had two of those procedures or one plus flutter but all three is probably rare.

You can do a search of the AFA forum for mentions of each item separately.

My experience is only of flutter - makes you feel like death but relatively easy to fix with an ablation, otherwise seem to need a heavy dose of meds which also cosh you.

Hope that helps 💜

[Lagun68 in reply to Buffafly]

Thanks for the reply I will look at the AFA forum as you suggest. I did read somewhere that Coronary Heart Disease can be a potential cause of Flutter and now that has been fixed so to speak (stent implant) this may have an impact on future episodes. Time will probably tell and I will need to discuss this further with the cardiologist.

[willywombat44]

Hi Lagun68. I am not quite sure what you want to hear but I shall relate my experience.

I was diagnosed with PAF in 2014 but my experience of it appears to be different to everyone else here in that I am bradycardic instead of tachycardic (slow instead of fast erratic heartbeat on occasion). I was prescribed Apixaban and have not seen anyone since regarding that diagnosis.

In 2019, following my own suspicions, I had an angiogram which resulted in two stents being inserted. As a consequence I now take Clopidogrel every day in addition to the Apixaban which is not a good combination but apart from hoping that I don't have an accident whereby blood loss may result I live a very active, happy life at 76. I wish you the same.

[Ianc2]

Ask to see an EP. Flutter can usually be fixed by an ablation and is very straight forward procedure. It may be worth considering a private consultation to get the ball rolling. I had one done , as a day patient , after valve replacement and it was successful.

[Lagun68]

Thank you both for your responses I am due to speak to my cardiologist next week and hope to get a better idea of what treatment is proposed for Flutter. As you say the success rate for ablation for Flutter seems quite high 90%+ so it will be something to consider. Since coming out of hospital following the stent implant I have not had any instances of fast heart rate but amongst other drugs I am on Bisoprolol plus clopidogrel and apixaban which I presume will have an effect for Flutter.

[KMRobbo]

I am not medically trained.

Apixaban is an anticoagulant. it has no direct effect on flutter other than there may be a potential for blood to pool in your atria owing to incomplete evacuation of blood from your atria owing to the fast rate. ie (atria quivering not completely emptying the blood which can then coagulate and be a stroke risk.. I am not medically trained so it may also be something to do with your stents - no experience there.

Bisoprolol is used as a (heart) rate control drug. Flutter can be very fast in the atria, which can result in a very fast ventricular heart beat. The Bisoprolol will limit that rate to some extent.

I developed Aflutter after a successful afib ablation (for reasons I won't expend on here) , and I was taking 200mg of Diltiazem hydrochloride as rate control. My HR even rate controlled was a pretty constant 140 bpm per minute. I took diltiazem (a calcium channel blocker) as I could not tolerate the two beta blockers I tried , one of which was bisoprolol. A lot of people do not get on with bisop. It is not a bad drug, many people appear to like it and it helps them but it appears we are all different with drug responses.

Bisoprolol is a blood pressure drug. It reduces blood pressure and heart rate. The latter explains why it is used for AFIB/ Aflutter .

However it can reduce one the other or both (?) too much . Tiredness is a typical side effect.

So it could be the bisoprol. However for all I know any of the other 5 drug you are taking could also do the same. Suggest you read the instructions leaflet with each of the pills (which will be a massive list, but may give you something to clarify in the telephone call with your medics).

Maybe it is also a result of the angioplasty??

Bisoprolol had a severe effect on me. My resting hr was normally 68-72, but on Bisop it was in mid 40s. My GP was happy to take me off it as she thought my HR would be in the mid 30s when I was asleep , which she felt was not a good number with a normaI HR in the 70s. I was exceedingly tired, I was asleep 40 minutes after every one of the 8 1.25mg (daily) pills I took I could not run more than a 100 yards as I my max HR was 117 ish bpm.( I was running 6.4 miles in 50 mins the week before, max HR well into the 180s).

I believe I am quite extreme in this reaction, clearly you are not as bad, but still may help with your discussion.

Best wishes

[Lagun68]

Thanks for your response. Yes the apixaban is for anti coagulation purposes as well as clopidogrel for the stent side of things. I am on 2.5mg of Biso daily and this does knock my resting HR down to late 40’s/ early 50’s so this may be the culprit for the tiredness.

As this is only week 4 of the meds hoping things will settle as body gets used to them.

If not will have to see about adjusting/changing.

Once again thanks for the response.