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flutter not fibrillation

Dogmad2 profile image
32 Replies

Hi all

I have paid to see an EP (privately) today who has confirmed 100% I have atrial flutter and no fibrillation? Anyone else just have flutter?

He has recommended an ablation to sort it out and told me to stop taking Flecainide which makes me nervous. He says it probably isn’t doing much and could make things worse. Anyone else had this advice?

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Dogmad2
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32 Replies
Jalia profile image
Jalia

Yes I've had just flutter and had ablation for it. It's much easier and quicker to ablate as normally entered on the right side thereby avoiding piercing the septum to access left side for AF ablation.

Personally I found A flutter very troublesome as it seemed relentless. I do hope you get sorted out soon. Is a cardioversion possible to tide you over until ablation appointment becomes available?

I have very recently had a 6 day bout of Aflutter for hours at a time interspersed with Afib and was dc cardioverted last week.

Cookie24 profile image
Cookie24 in reply to Jalia

As you say, flutter is relentless

mjames1 profile image
mjames1

Daily Flecainide has kept me out of both afib and aflutter. That said, when I'm in aflutter, I have been told not to take Flecainde because it can make the aflutter worse. That may be what your ep is talking about, or perhaps daily Flecainide isn't keeping you out of aflutter, so why take it.

As to ablation, for what is termed "typical flutter", they only ablate the right side and it's a much easier procedure with a higher success rate than an afib ablation, however the flutter ablation can sometimes bring out afib, if you have any. That's why it's important to rule out any afib with a Holter monitoring, prior to an aflutter ablation. Should they find any afib, they often will then do an afib ablation as well.

Jim

secondtry profile image
secondtry in reply to mjames1

Hi Jim, could you please describe your feelings when in aflutter compared to Afib.

Recently I have had puzzling very short bouts of something different to in my AF past. I am also on Flecainide long term.

Speed profile image
Speed in reply to secondtry

I had AFlutter, treated by 2 Ablations and subsequently developed AF. The feeling was very different, though with my AF I’m not very symptomatic and only realise I’m in AF whilst running because I’m constantly checking my Garmin HRM. When not exercising I often don’t realise for hours.

AFlutter was a very distinctive flutter in my heart, like what we referred to as “butterflies”when nervous as a child and initially I thought / was diagnosed as suffering from anxiety - it really did feel like that.

mjames1 profile image
mjames1 in reply to secondtry

Initially -- without an ekg from my Kardia or Apple Watch -- I really can't tell the difference. I suppose I could tell by pulse at the wrist (flutter is fast and regular, my afib is fast and irregular) but I always have my Watch and/or Kardia with me and is far more accurate than trying to determine if a very fast pulse is regular or not.

In terms of how they behave, my rate with flutter tends to be around 130-140, while with afib it's higher. My flutter episodes are also shorter (5-40 minutes) while my afib episodes could go on for days, prior to PIP Flecainide. Because my flutter resolves quickly, I don't usually take any meds although lately I take some Diltiazem in case the flutter turns into afib, which it sometimes does. That way I will have some Diltiazem in my system should I decide to take PIP Flecainide.

But again, while daily Flecainide can prevent flutter, you never want to take PIP (extra) Flecainide when in aflutter. PIP Flecainde is reserved for afib. Another reason, the Kardia or Apple Watch is very helpful so I will have more confidence in what arrhythmia I have, prior to treating it at home, not to mention giving the ep useful information for possible future interventions.

Jim

secondtry profile image
secondtry in reply to mjames1

Thanks, did not realise there was a Flecainide ? Flutter problem. Much appreciated.

mjames1 profile image
mjames1 in reply to secondtry

Flecainide has pro-arrhythmic qualities that in rare cases can turn 2 or 3:1 flutter into life threatening very, very fast 1:1 flutter. That's why a nodal blocking agents such as bisoprolol or Diltiazem is often prescribed along side it.

The irony is that daily Flecainide can be very effective to keep you out of flutter, but once you go into it, do not take more. At least according to my ep.

In my case, my flutter episodes often turn into afib, so I only take the PIP Flecainide when I can document afib on my Kardia or Apple Watch.

Jim

secondtry profile image
secondtry in reply to mjames1

My cardiologist forgot to mention this, although to be fair he knows I struggle to keep manageable anxiety and he probably didn't want to add to that issue by talking about Flutter possibilities.

BenHall1 profile image
BenHall1

back in the day .... Jan 2010, my flutter converted into Afib. Was anything said to you about this possibility.

Dogmad2 profile image
Dogmad2 in reply to BenHall1

Yes he did say that was a possibility. Referred me for an ablation so got a few months to give that some thought!!!

How did the 2 feel different?

BenHall1 profile image
BenHall1 in reply to Dogmad2

the flutter felt like a bag of earth worms wriggling away or several squadrons of butterflies in a dogfight oin my chest. The AF itself just felt like a heavy weight was in my chest dragging me down and stopping me breathing which was becoming very laboured.

bassets profile image
bassets in reply to BenHall1

Thanks this is very useful.

BenHall1 profile image
BenHall1 in reply to bassets

No worries. 😊

Rosie1066 profile image
Rosie1066 in reply to BenHall1

I had it the opposite way round - my AF turned to Flutter and also to Slow AF. Eventually had a pacemaker fitted due to Tachy/Brady Syndrome.

Paulbounce profile image
Paulbounce

Hi Dogmad.

I've had both - at the same time I add. Futter is fairly easy to treat with an ablation - it a very high success rate.

Good luck.

Paul

Bingofox007 profile image
Bingofox007

I was diagnosed with PAF in feb ‘22 and given flecainide but cardiologist stopped it a couple months later as it had caused flutter. I have been advised I need to lose weight before ablation and so doing that with very low/no carb diet. Losing weight is actually improving the flutter but many more kg to go until ablation on the menu. Take care 🦊x

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

We don't give enough information on your levels.

H/Rate at rest?

BP? at rest

cheri JOY. 75. (NZ)

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to JOY2THEWORLD49

Hi

Sorry

We don't have enough information on your levels.

...JOY

BeeBee79 profile image
BeeBee79

from my understanding, ablating flutter is much easier than ablating fibrillation as they know exactly where it comes from. I’d definitely go for it! 🤞

Speed profile image
Speed in reply to BeeBee79

As part of the procedure they do a full electrophysiology study to map the heart and identity the area causing the AFlutter. They then burn a line to break the circuit. Not always successful. On my follow up they had to do 26 further burns to zap it. All under sedation not GA. Procedure no issue and in a way enjoyable- quite fascinating to experience! What makes it simpler is if typical right side flutter, they don’t have to piece the septum to get to the left Atrium which they do for AF (or is there atypical AF in the right side 🤔).

BeeBee79 profile image
BeeBee79 in reply to Speed

Forgot to add simpler for atypical flutter which is what I’ve had - 4 ablations in total and no success for me. Cardiac surgery next….

TracyAdmin profile image
TracyAdminPartner

Have you visited the AF Association webpage? You will find a wealth of information regarding atrial flutter heartrhythmalliance.org/afa... choose to view some of our many video, download our resources, and register for our online Patients Day currently available on demand - heartrhythmalliance.org/afa...

To download visit: api.heartrhythmalliance.org...

Alternatively, our Patient Services Team are more than happy to help; heartrhythmalliance.org/afa...

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jeanjeannie50 profile image
jeanjeannie50

Yes, I was told to stop taking Flecainide as it was making my heart rate worse. Just stayed taking Metoprolol and my energy levels increased dramatically.

Jean

Ppiman profile image
Ppiman

I was similar in 2019. If you search my early posts you will find lots of help as some of the replies from people here were really useful and helped me through what, back then, seemed a very bleak time.

Steve

ETHEL103 profile image
ETHEL103

Yes I had an ablation for what I thought was fibrillation in 2022 but they did it for flutter as they couldn't induce the fibrillation. Turns out my Kardia diagnosed poss a fib that was in fact lots of ectopics and flutter.Flutter ablation has a good success rate so good luck to you .

wilsond profile image
wilsond

I had both. Flutter can be much more successfully cured than AFIB, by ablation. I think its 95% success rate first time.

Speed profile image
Speed

Whereas a Kardia doesn’t specifically identify Flutter, a 12 lead ECG / EKG shows up a very distinctive “saw tooth” pattern on one of the leads.

Mugsy15 profile image
Mugsy15

You give (me, anyway) the impression that you had your first meeting with this EP, without wearing a Holter monitor or similar for a few days beforehand.

If that was the case then I'm surprised at the apparent certainty of the diagnosis. They can confirm that you had Flutter at the time but cannot state with any certainty that you do not have AF too. Any readings you had taken on the day are very much a snapshot of what your heart was up to at that particular time and Paroxysmal AF is notoriously difficult to capture in this way.

Maril1 profile image
Maril1

Some good news here . I was diagnosed with permanent Aflutter in 2006 . They tried every drug and combination under the sun and nothing worked only cardioversion with the pads but it would come back a year , few months later . Had up to half a dozen of these before they gave me an ablation which touch wood was a CURE. But I have proxy afib which I treat like other people treat a head ache these days . With me Flecanide works with Afib . I only take it when an episode comes on at an inconvenient moment , mostly just let it run its course 2 to 6 hours. Incidentally abroad on holiday back in 2006/07 heart went into permanent Aflutter. Said to the wife I’ll just carry on as normal for the kids sake not to spoil week away so I thought I may as well have a few pints can’t do any harm now . After a couple of Lagers my heart would revert to normal rhythm until I got out of bed the next morning. Note I use this method when I’m abroad as a couple of swift ones can do the trick with Afib even quicker the Flcanide!

2learn profile image
2learn

hi, don't know what I've got cos every time I see a different consultant they call it different so I have flutter some times and not others, Don't know whether this is possible or just docs not being sure.

mjames1 profile image
mjames1 in reply to 2learn

Even ep's can differ on reading ekg's. Flutter, atach and even afib can sometimes present in a similar fashion. I've had ep's look at the same strips and like you have gotten different reads.

Jim

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