AFib vs Aflutter: Can anyone describe how... - AF Association

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AFib vs Aflutter

Nigel2000 profile image

Can anyone describe how they feel with AFlutter vs AFIB? That is, of course, if you’re symptomatic. I wonder if what I’ve been feeling as AFIB is sometimes AFLUTTER. I also wonder whether it matters? My iwatch captures the Afib, but often I have symptoms (wonky heart jumping around), breathlessness, high but not very high heart rate which the watch reads as either SR or inconclusive. Any feedback appreciated, 😊

25 Replies
BobD profile image

Take the watch off, learn to take your own pulse and it is easy. Flutter is fast but regular. Fib is chaotic. You dont need a machine to tell the difference.

Nigel2000 profile image
Nigel2000 in reply to BobD

Thank you!

Elli86 profile image
Elli86 in reply to BobD

🤣🤣 you really do hate tech Bob don’t you.

Elli86 profile image
Elli86 in reply to BobD

Honestly mate I get where your coming from and understand some people can get addicted to it but just as many people find it extremely helpful like myself. Many EPS are recommending getting one now as well because it allows you to take hold of your health and keep track of your progress. I think you should caveat your advice of throwing it in the bin with saying how some people could find it extremely helpful, and they do!

Wearable tech has been recommended by every EP I’ve seen so far and plays a central role in the book “the afib cure” about how to get your health to where it needs to be in order to get off the drugs and give AF the boot.

Not having a go just saying as someone who may have found the tech extremely helpful may read your post and be put off entirely 😃👍

john-boy-92 profile image
john-boy-92 in reply to BobD

My body is awkward and during a Bruce Protocol test flip flops between the two. During cardio execise I can watch my heart rate - otherwise it will hit 190 - but physically I don't feel anything whether it's steady at mid 150s, or wandering about with jumps of ten beats/minute.

Dofetilide effect possibly? Slow flutter can feel like sinus rhythm. Maybe send it to your cardiologist?

Nigel2000 profile image
Nigel2000 in reply to

Thank you!

I had atrial flutter in 2019, then an ablation, then a day of persistent atrial fibrillation which responded to bisoprolol and went away.

Without medication, my pulse was fast with both, and was never "chaotic" at any point with either, which is different from what some report for afib. I felt truly terrible with each, having to breathe deeply as if out of breath; I felt light headed as if about to faint; in sum: I felt truly awful and, naturally, very anxious. You can read what I wrote after my afl ablation here:

Now, I have an elderly friend who is now 87 and who has had persistent fibrillation for many years. Again, his pulse is regular and not chaotic but in his case, he has almost no symptoms. He has never been treated medically except with warfarin.

What I think makes the difference is what happens "down below", in the two lower chambers of the heart called the ventricles. What is happening "up above" in one or both atria is not always important (and, I have read, rarely physically felt) because this activity is always modified by the "sino-atrial node", a structure that regulates the beat of the two ventricles (and which creates what we can always feel, the pulse).

If this structure still manages to do its job effectively, then the heart will be pumping well, will not be weakened and will not show any physical effects from the arrhythmia. If this node is unable to do its job well, tachycardia will often result (and often a fast but irregular pulse in the case of afib); also, if there are other "electrical conduction" events happening such as a partial heart block (I had some degree of left-branch bundle block, for example), then some degree of "heart failure" will develop as the heart will not, during these events, not be able to pump efficiently (i.e. its "ejection fraction" will be lowered). In this case, the body will be in some state of shock and react by feeling anxious and poorly. It might eventually get used to this new state of affairs and many people live happily with a reduced ejection fraction, whereas many continue to feel weak and awful.

I was told that afl is more likely to reduce the heart's pumping capacity which is why many with is feel worse than those with afib.


Nigel2000 profile image
Nigel2000 in reply to Ppiman

This is very helpful, thanks!

I had both. When I first went to emergency in 2009, they diagnosed AFIB. And I consulted with a Cardiologist and he said I had AFIB. However, when I saw the arrhythmia specialist EP, she was adamant that I had atrial flutter.

Now it does matter which one it is, because treatment is easier for flutter. For flutter ablation the EP works primarily in the right atrium eradicating electrical hotspots to get rid of it. And it has a higher success rate than AFIB ablation.

AFIB is more technical and risky because the EP has to puncture the septum wall between the chambers to get to the left atrium where they do extensive work around pulmonary arteries and other delicate areas.

A competent EP is the only one I listen to about arrhythmia diagnosis.

Hi Nigel.

My symptoms feel very similar but my “flutters” don’t last more than a couple of minutes if that. Makes you feel a bit panicky at times as your certain your going into AF but doesn’t usually materialise.

In regards to the watch I bought one a few months back and it’s been superb for me personally. Brilliant for tracking everything and keeping on top of your health and how your hearts behaving. Excellent for giving yourself a quick ecg if you feel like your hearts playing up and putting your mind at ease. Just don’t become obsessive with it, some people do, no idea why personally I just use it too track my health overtime and put my mind at ease as/when I feel like my hearts playing up.

Understand bobs point of view but for me it’s been nothing but a revelation. Read “the afib cure” it’s great all round and has got a good section on wearable tech, why it’s so valuable and why you should get one 👍

What BodD said I had flutter Cardio said if your going to have one that’s the better of the two. I had an Ablation in December all’s well just on Apixaban

I have had both since Oct last year and cannot tell the difference in symptoms but it maybe because they are occurring at the same time. The first time I had flutter on its own, I could not tell my heart was doing it and it was only because I had an ECG that it got picked up before it quickly converted to AFib.

I have been diagnosed on separate occasions with AF and Flutter. All occurrences have been persistent. I can feel things ain't firing properly but physically i can't tell the difference between the two.I was offered an AF and flutter ablation, but elected to just have the flutter ablation as that what was being seen at the time and i was more comfortable with the "easier" procedure.

I have been in NSR since the procedure 3 yrs ago 🤞

Atrial Flutter can give you either a very regular pulse due to a fixed block ratio between the top chambers (atria) and the bottom chambers(ventricle) or it can give you an irregular pulse like AFib if you have a varying block ratio. The problem is that any Lead I device (between the left and right hands) will probably not show the characteristic flutter waves of AFlutter. That is one reason we developed our Kardia 6-lead. Lead II (left leg to right arm) provides the best view for Atrial Flutter. If you have a regular pulse rate near 150, 100, 75 or 60 bpm you could have Atrial Flutter with corresponding 2to1, 3to1, 4to1 or 5to1 block ratios. Without a lead II your watch may call it NSR or inconclusive as it’s regular and not irregular like AFib.

Yes absolutely. There's a brilliant video I watched which has a digital heart doing the two different things which made me realise I was having flutter and that after a while of flutter it was going into afib and then back to flutter and then away again. Flutter for me was like my heart stopped beating and instead of beating it was purring like a cat ..or like an old telephone kinda thrumming...the actual brbrbrbr was a regular rhythm...but insanely fast... More like a vibration than a fast beating of a drum...think of the fastest drum roll brbrbrbr ... And then the paces between rolls was irregular... Br brbrbrbrbr brbrbr brbrbr br brbrbrbr like that. And then as far as I udneratand it the afib is when the heart beats really fast... So like a drum you're banging on but very fast...and my heart was also doing that after the fluttering.... And mine was like ba baba bababa ba baba ba. Thankfully the lifestyle changes I've made have made it stop ..once I knew what it was I was able to find out about it and help myself. A lot of things can cause it.simple things like dehydration ...iron deficiency..tobacco... I have magnesium deficiency I assume because magnesium stopped it within hours and I took that for a week and then stopped and it returned so now I take magnesium every day and try to drink enough water. I also take cayenne pepper to thin my blood and or event thickening of the heart walls which happens as the walls of the heart struggle. I'm walking more worrying less taking hot cold hand and foot baths for my circulation. My brain fog is clearing up. My exhaustion is getting a bit better. I'm delighted because I'm only 40 and looking on here people seem to go from one surgery to the next without ever any mention of lifestyle changes or diet or deficiencies being found ...and I do wonder if some people were in my position years ago and never figured out the cause of it and it may have been something simple as it was for me. So simple. Doctor didn't notice it. Was actually a random stranger years ago when I had arythmias that mentioned magnesium and it worked for me then but I kinda forgot about it and stopped taking it for years. But thankfully remembered ..doctors said everything was normal and there were two things high which can cause palps which doctor never noticed or mentioned. I'll Try find the video I watched which helped me to figure it out.

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Hello gonnamakeit, yes I'd love to see that video when you find it. Please let me know. Happy Easter if you do celebrate it.

in reply to

Thanks. I didn't save it and it was only a little embedded two minute thing so I can't find it now. But I did see a few of afib just now but didn't see any on flutter. I am not sure they're entirely different things ...except that afib can make the whole heart spazz out of sync and I don't think aflutter does that. I thought I knew from that video but now I've just watched two other ones that seem totally different. Anyway I should just pay it no more attention and leave this forum because I'm fine now. And the reading about it is very tiring and worrying. Hope you have a nice easter too and that you figure it out and get better soon. :)

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It's hard for me to keep them apart ! Thanks.

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Yeah I had to lie down really quietly and really try to get my mind into my chest. At first when it happened all I knew was my heart wasn't beating.and I was like...OK but I am alive....then I could hear the buzzing sound... Then later I could hear the regular buzzing and the irregular distance between each buzz. Then eventually I could distinguish between the regular buzzing aflutter (as I think but lament sure it is) and the irregular spazzing of the afib. I think from vids I've seen of the afib its very spazzy erratic chaotic ...anyway took me a long time to kinda hear/feel them. Once I realised I wasn't dying lol!

I had afib and atypical aflutter. I think aflutter made me feel worse. With afib my meds could lower my heart rate and I could go about things better. With aflutter my heat rate was high and could not be lowered as much as the afib. My activities were more restricted. I went from paf to persistent. First ablation was for afib and I was good for 14 months. Needed a second ablation for atypical aflutter (more difficult to treat than typical aflutter) and I am good for now.

I had afib , apart from the high heart rate of up to 190 resting but very variable from 130, I was asymptomatic. I could run when in afib. Had a PVI cryoablation, successful , and 9 days later developed reentrant atrial flutter , rate controlled by 200mg Diltiazem at a very consistent regular 140bpm.

I was breathless walking from living room to the kitchen for a brew! I spent nearly 4 weeks lying down waiting for a flutter ablation which fixed it, as I could not really do much else ( read a lot of books and listened to a lot of music!).

Massive difference in the symptoms between the two. ( for me) . Not medically trained but Cleary the right atria was preventing blood being pumped successfully through my lungs.

Ps dont let the flutter issue put you off an ablation. It was very probably caused by the flecainide I was till taking for the afib.

Anyway 3 years 2 months later I have neither afib nor flutter and have not taken any drugs since May 2018

I was diagnosed with Atrial Flutter after steadily becoming more and more breathless, incidents of quite horrible palpitations and near black-out episodes. It escalated over about 3 months to being persistent and really quite debilitating. I could barely walk up the stairs in the house without my heart going into a spin. I have on this thread that atrial flutter can feel "worse" than atrial fibrillation and was told the same by cardiologist and EP - though both said it is a "safer" arrhythmia.

As it goes, this was the beginning of a bit of a rapidly escalating saga for me that ended up in open heat surgery 10 weeks ago. That's off topic from your post so won't go into it but there is a good possibility that the flutter may have been a symptom of the pressure caused (particularly on the AV node) by some more urgent aorta / aortic valve issues. There was not time to verify this connection so the approach taken was to treat the flutter as its own issue. My surgeon and EP I had initially seen worked out an ablation strategy to do as part of the open heart procedure. So far, so good....

Glad to hear you’re doing better. Very helpful response, 😊

Thanks. And I hope you get sorted too.

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