Atrial Flutter and Fibrillation

[zico77]

I was diagnosed with an atrial flutter late last year and was prescribed bisoprolol which has increased up to 5mg a day. I’ve not been feeling well of late with bpm like a yo-yo. I’ve also had a severe chest infection/ fluid on lungs which hasn’t helped. On Friday of this week, I was diagnosed with a second heart condition (atrial fibrillation) which came as a shock. The cardiologist has said that he can perform both ablation procedures within the one hospital visit and would recommend that this is done under general anaesthetic. He’s told me to take the information away and think about it as it was a lot to process. I’m approaching my mid forties and just wanted to canvass opinions on whether to keep these procedures separate or just bite the bullet. Appreciate that there is increased risk of complications and a longer recovery time but the prospect of going through this process a second time is very unappealing.

[BobD Volunteer]

Without getting too technical they are best done together. In order to reach the fibrillation the catheter has to pass the flutter so best done all at once rather than separately. Only one lot of GA and less chance of any complications regardles of how rare.

Go to AF Association main website and read all the fact sheets on ablation found under patient resources for better understanding .

[zico77 in reply to BobD]

Many thanks for the prompt response and reference to the fact sheets. The cardiologist also mentioned the potential for a pacemaker depending on how the procedures go. I must admit thats rocked me too on hearing this.

[BobD Volunteer in reply to zico77]

That is a long way away yet.

[CDreamer]

To ablate or not to ablate - many different views on this subject and if you read through the posts or put in a search you will see that this is an often asked question.

Firstly - it’s much easier to ablate the Atrial Flutter in as much they the catheter is guided up through to the right atrium to ablate both Flutter and Fibrillation. To get into the left atrium a small puncture needs to be made in the dividing wall so to gain access.

If you are going for ablation it would make sense to me to have it one go for several reasons - recovery after the procedure and one arrythmia often begets the other and both together are absolutely misery.

An experienced EP - and ensure it is an experienced EP who regularly performs the procedures together - will assess when and where to stop and you may need a second ‘touch up’ procedure anyway, as many of us have experienced. Ablation is thought of as more a course of treatment than a one off ‘cure’ and the people who have had only one ablation and it has worked rarely stick around this forum.

May I suggest several courses of action in the meantime - Firstly my arrythmias are always at their worst when I have an infection and it takes quite a time to recover from chest infections. Wait until you have completely recovered before making any decision and in the meantime - research and a good place to start is AFA website.

Many of us have also gained a lot of insights as to the causes and management of these arrythmias from a book called The AFib Cure. Medical interventions are all very well but there is a huge amount you can do to help yourself and information of what and how is essential.

Another website which I found very useful for research was this blog by an EP with AF who also is an athlete

drjohnm.org/2014/02/13-thin...

His thoughts on ablation

drjohnm.org/2015/09/a-cauti...

Hope some of that helps.

[zico77 in reply to CDreamer]

Thank you for the advice. It’s certainly taking a while to fully get over this chest infection. I shall follow up on the information and book reference you’ve provided. Ive not slept very well since learning of this second condition so understanding more about this and the grand scheme of both is paramount for my mental well-being.

[CDreamer in reply to zico77]

AF is not normally life threatening but can be life changing as it focus your attention on your health & improving your wellbeing.

Anxiety comes with the territory because it’s our heart. Managing the anxiety really helps the heart and worry & stress make things worse which is why educating yourself really helps.

Arrhythmias are not like having cardiovascular disease which can be life threatening but it can be a symptom of an underlying condition Thyroid being one so . make sure you’ve had a Thyroid test.

I always found AFlutter more symptomatic than AF on its own. I developed AF then AFL but many people I know the other way around.

[Jalia]

Hello Zico , following on from what BobD has said , many if us have had ablation for A flutter and A fib at the same time so nothing unusual there. In fact I had ablation for both of these plus Atrial tachycardia a few weeks ago.

I was diagnosed with Atrial fibrillation etc in my late forties , 28 years ago , when ablations were in their infancy. I waited 16 years before having my first ablation.

Most likely if I had been able to have had my initial ablation earlier it would have saved me many years of disruption to my lifestyle and multiple procedures in the ensuing years.

So my advice to you is yes, do bite the bullet and get this tiresome condition behind you if you can with of course lifestyle changes if appropriate.

Best wishes

J

[zico77 in reply to Jalia]

Thank you J. This forum is very helpful and supportive. The cardiologist has told me that I need to change diet and completely cut out alcohol. I stopped drinking coffee 8 months ago. My medication is under review and I need to continue strengthening my heart through more regular exercise. A sedentary job coupled with working from home hasn't done me any favours.

[CDreamer in reply to zico77]

Those lifestyle changes are really important as no use having an ablation if you don’t change behavior as the will probably return.

[afhanhound]

I had a similar condition with AFib abd AFl. Was offered the choice of a catheter ablation for both at the same time (lower success rate 70% and greater risk of collateral damage and longer recovery) or just treat AFL with an ablation. My initial reaction was to go for both at the same time but I then paid for a private consultation with an EP to seek advice. His view was better to have just one ablation (to start with) on AFL due to its higher success rate (95%) as there is a likelihood that AFL causes AFib, but if it is not successful then at least effort can then be concentrated on AFib either with medicine or with another ablation. I had mine done about a month ago and came off 2.5 mg Bisoprolol and given Fleccanide as a PIP instead. So far had several ectopic beat sessions and a short spell of Afib (used PiP) after a couple of weeks which I gather is pretty much the norm after an ablation. As others have mentioned AFib/AFl takes many forms and effects people differently and even EPs and Cardios have different views!. I have also reduced my alcohol and been careful about not overdoing physical activity.