Please help me everyone. I have had long episodes of persistant atypical flutter probably caused by a severely enlarged left atrium . Ive been a lifetime long distsnce athlete, mainly cycling.
I was offered av node ablation and pacemaker about 6 mths ago. I have had days of semi reprieve from it over the last 3 yrs sometimes for several weeks or just days.
Last week i was contacted by the hospital and it will be only a few weeks before i am done.
Now i have gone into sinus rythm a few weeks ago and am quite a lot more comfortable as ot mainly the the arrythmia uneven beat that makes it hard to tolerate etc.
When it goes like this for a while i keep thinking, Oh im coming right and i dont need any form of intervention. Its like it plays cat and mouse with me. Now its really decision time do i go ahead.
They say it never goes away so i must be realistic. What do you similar experienced people say. Maybe this all sounds stupid but when your there yourself it doesnt.
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Alphakiwi
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My experience was - it only ever went away for a while. I was heading toward persistent AF with episodes lasting 6-12 hours about x3 weekly and not able to recover fully from one before the other started. I had done the drugs, had 2 ablations and the Lifestyle - managed stress, good sleep, excellent nutrition and moderate exercise so it was either Amiodarone or Pace and Ablate - I chose the latter. Your can follow my posts from 2018 when Pacemaker was implanted.
Not everything went to plan but I started to feel better the moment the Pacemaker was implanted. 6 weeks I was still feeling good, despite my ‘hiccups’ - Left Ventricle Lead was misplaced - no AF and HR & BP steady - 1st time in 7 years. I couldn’t see the usefulness of going for the AV node ablation - just because so had a consultation with EP who said that this had happened for several of his P&A patients.
I had the LV lead revised and since then I have only had 2 very minor episodes of AF when I had a virus and one more serious episode when it was uncomfortable but still not nearly as symptomatic as I had been - so for me the Pacemaker alone has improved my QOL beyond all my expectations.
Be aware that if continue to have AF and you have the AV node ablation you may still continue to have AF and feel it but that because your pulse is paced, the debilitating symptoms of AF should be much less.
Thanks for the ecouraging reply. I was put on amioderine and ended up flat lining in ambulance after 10 days of trying to tough out the side effects. Then i went on sotolol and got to 4 days and had to chuck those. Dame thing with Diltiazem so doc tried me on low dose of diltiazem as a pill in the pocket approach. That sort of works. Im 79 and in good nick otherwise. Just dont want to spend my last years miserable79 ? Well what the heck and yes maybe i wont need the whole works like you found.
Hello, if you would like any information about your upcoming procedure, please feel free to visit the A F Association website, we have patient information booklets and online videos presented by health care professionals that you might find helpful. Take care, Tracy
If I was in your situation ... I would get a 2nd opinion by one of the top EP's in the world (if you can swing it). Severely large atrium doesn't sound all that good.
All my ablations have been with world-class EP's. They can do some miraculous things nowadays. Even if it doesn't pertain to an 'ablation', they still might have other options to consider.
I was in exactly the same position as you. AFlutter that would be present for 3-4 weeks permanently and then I would flip back to normal sinus rhythm and would tick along nicely for a few weeks with just the odd short lived flutter. I had the same decision to make last week. I was booked for an ablation last Wednesday morning and the fact that I had had three weeks of tranquil normality really stressed me out because I didn't know if I should have the ablation or not. I sat on the hospital bed with the consultant before my op and asked the question - can AFlutter repair itself? Consultant said exactly what I knew. It might be dormant for a while but then something will trigger it and off it will go. Having had 15 months of the stress of AFlutter I bit the bullet and had the op. According to the surgeon, I went into AFlutter literally as I was on the table, which made life nice and easy for them (although they could have induced the flutter by medication). I am a week post op now and getting stronger and better by the day. The op itself went well. I was sedated, didn't feel a thing. Most of the time I was 'asleep' but I did have a couple of more conscious moment and just found the process completely fascinating (which is a bit bizarre when you are on the operating table) - but at no point was I in distress. Other than initial chest pain, which has got better day by day (am feeling quite normal now), I've had no side effects. I know it's early days, but I'm hopeful that the op was a success and that I am free from the beast of AFlutter. Good luck in whatever you decide.
I never had to make a choice as despite already having a pacemaker I had persistent AF and felt permanently dreadful with it. This is only my individual experience but I would just say that if you do end up having the full deal, within an hour of the ablate part my quality of life had shot up and I felt like a normal human being again - and after two years it hasn't changed.
I had pace and ablate six years ago and have never regretted it. I have now apparently gone into permanent afib but am unaware of it because of the operation. I can now live a more normal life again.
I am in exactly your shoes, 78 and in persistent atypical flutter. It is important to distinguish between AF and atypical flutter; they are definitely different and whereas one (AF ) may require pace and ablate, the other atypical flutter may not.
Here are some sites you may want to look at that describe atypical flutter:
Have you had other ablations (I have had three)? Were you told why you should have a pace and ablate?
In two days, I will have a 15 minute (timed) consultation with the local EP. I will refrain from making a comment on what I suspect the outcome will be. More importantly right afterwards, I will contact my Bordeaux group ,who did my three ablations ,on what my prognosis should be. I do have an extensively ablated heart due to the 6 months persistent. Atypical flutter can develop as a result of extensive ablation.
So, my suggestion to you is the same as The--Lord--is--with --us to get another opinion, especially with regard to getting an ablation for atypical atrial flutter. And, if it is in the left atrium, ask if they do ethaneol injection of the vein of Marshall should the atypical flutter be around the mitral valve. They may not be up-to-date on technique and therefore offering you only pace-and-ablate.
You also talk about "uneven beats" which is AF -- irregular irregular. You say you have atypical flutter -- regular irregular. So, was your ECG interpreted as atypical flutter? You might want to find out exactly what is happening before you go for pace and ablate especially since with pace and ablate, the flutter will still be there.
You can pm me privately if you want to know the results of EPs viewpoints.
Many thanks for all the replys Here is a bit more info om my condition.
Im 79 in 2 months and have considered something was wrong about 8 yrs ago.
Drs didnt find any way of fixing short breath attacks when cycling and sometimed shaky and woozy when mowing lawns etcetc.
Finally when training for world masters games cycling i started noticing steep spikes in heart rate so i started annoying the drs again. Told nothing wrong. Eventually i decided to run to the doc. Sure enough he noticed something wrong and put the ecg gear on me but it was to late. Nothing. I went to a specialist . Ran over to his rooms and he pit me on the ecg and there it was. Even beat but a 4 to 1 flutter.
I was cardioverted and on rivaroxaban. That lasted for 5 months but always more tired than usual. About a year ago i fell off top of ladder and had tachycardia. 110 bpm day and night for 3 days. Dr put me on large dose of digoxin which got it back down. Went off that. Was put on Amioderine at dome stage and i flat lined on that in ambulance after 10 days. Tried sotolol and after 4 days had enough. Tried diltiazem . Couldnt handle that so took small dose diltiazem et night and as required at during night and day. Pill in pocket aporoach.
Got to see Nigel Lever from Auckland, considered one of the EP here. Viewed my ECG. Did Echocardiogram which showed i had an extremely enlarged left atrium. Apparently the electrics go the other way inside the RA and rules out ablation. I heard him refer to the echo tech thay my LA was a whoppa. He took all my stats back to the team.
It seems I have Atypical flutter . It was pyroxysmal but went persistant. I think the rythm became uneven after the fall off the ladder.
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