Hello. I'm hoping that those with more experience can help me! I have just been diagnosed with Atrial Flutter with rapid ventricular response and given bisoprolol 2.5mg as well as blood thinners. So, now my heart rate and blood pressure are within normal parameters - but I have a very "thuddy" feeling heartbeat. It seems as though my heart is beating hard even though everything is reading as normal. My GP said that's a common feeling, but it's very unsettling.
Do I have to learn to ignore it or should it be checked out further? Many thanks
Written by
Tremulous
To view profiles and participate in discussions please or .
You do learn to ignore it but can be unsettling. We AF’ers can be very sensitive to feeling palpitations. Apart from rate control & anticoagulants any further treatment plans? Have you been referred for more tests and/or seen specialist cardiologist?
Thanks, that's so comforting! I'm twitching at every thud at the moment - not good for lowering the stress level, it's a bit of a vicious circle.
I'm on the NHS list for an echo cardiogram and to see a consultant - not sure how long all of that will take. I've got a BP machine at home to get a week of readings for the GP and have got myself a Kardia Mobile, plus Fitbit, to keep an eye on heart rate - but resisting the temptation to check constantly!
That is important or it can be counter productive and produce even more stress. As CDreamer says we are all far too aware of our hearts and should eventually learn to ignore and get on with life but it can take time.
So easy to check and re check I do that and tell myself repeatedly distract yourself easier said than done . I’ve been fortunate recently to be offered therapy sessions, it’s def helping .
It's a normal SE of bisoprolol, you'll get used to it and it'good your HR and BP are normal, I get it with 5mg bisoprolol.If you are in normal heart rhythm any thudding or pounding is not AF
I can "hear" my heartbeat, particularly when seated quietly. I was told it's called Pulsatile Tinnitus. I used to find it a bit unnerving at first but I have got used to it. I actually find it comforting hearing/Feeling my heart in normal rhythm. That's why if I'm in AF I find it very unsettling. I know immediately if I go into AFIB. My meds (daily Bisoprolol and Flecainide) hold me in normal rhythm. I even find, when in bed, it sends me to sleep, relaxes me feeling my heart pumping normally. If I go for a brisk walk, or ride my mountain bike I can really feel my heart pounding, but it quickly settles down once I stop.
Sit upright in a comfortable chair. Try to relax mentally as you inhale slowly through your nose for 4 counts, then release the air through the mouth slowly for 4 counts. Focus your thought on something pleasant or neutral, such as simple math calculations or a simple, happy song that you hear your grandchild sing. (If they can sing in tune!, but you get the idea.) Finish with a few more cleansing breaths and go about your tasks without paying attention to your heart.
Sometimes, that procedure brings my BP down 10-15 points and lowers the HR buy 5 points or so. It might help calm the pounding heart. Also, try mild exercise (e.g. walking) with relaxed breathing.
Hi,I know how unsettling this can be especially when it's new to you but a thudding heartbeat isn't unusual. However, if your heartbeat or blood pressure move outside normal parameters you should see your GP.
My medication is keeping my heart fairly quiet at the moment 🤞 but I still have periods of the thumping. To be honest I'm so used to it by this stage that I just think 'here we go again' and ignore it.
I look on it as just a part of me, it's there and nothing unusual. This stops me stressing over it, and stress makes it worse so it must help.
Don't worry! And any concerns you have will be helped in this forum. I have found it a huge support, everyone is very helpful and I have learned a lot. I'm very grateful for all the help I've received.
I had the same problem. Eventually I bought some balanced electrolytes (the type athletes use) and experimented. I find about one third of a ml on the back of the tongue and a drink of water and after five minutes or so the thudding fades away to almost nothing. Now, I also take extra Magnesium and Potassium daily. The heart is an electrical organ and with AF it's working harder than ever before. I suspect the thudding is it's way of telling me it needs more electrolytes to be happy.
Please be careful with Potassium supplements and ensure you have regular blood draws for renal function. You should be able to get enough Potassium from your food when you eat a varied and healthy plant based diet.
Your GP is quite right. I had this in 2019 but, sadly, for me, bisoprolol alone did little and I was badly debilitated by the fast rate of 155bpm. Eventually I was given an ablation, which, thankfully, did the trick but, while waiting for that, a tablet called digoxin also helped bring my heart rate down to a level I could cope with.
A unique aspect of atrial flutter (which unlike AF is a conduction problem in the upstairs right atrial chamber) is that, most often, it produces a fixed heart rate, being a ratio of the atrial flutter rate, which is usually ~300bpm. The AV, or atrio-ventricular, node between the atrium and the ventricles, stops the main pumping chambers, the ventricles, from responding directly to the high atrial rate. This would be called 1:1 conduction and give an unsustainably high rate of 300bpm. Instead, the AV node limits the ventricular rate (i.e. the heartbeat) to various fixed ratios of the fast atrial rate. Hence, 2:1 gives a pulse of 150bpm, which you likely had as a "fast ventricular response" and which I had initially. Then there is 3:1, or 100bpm, which I had while taking bisoprolol, 4:1 (75bpm), and 5:1, i.e. 60bpm, which I had taking digoxin, and so on. My pulse occasionally fell to 45bpm (7:1).
The "thudding" you feel is the effect on the heart of the rate-controlling AV node on the ventricles. These are not beating entirely naturally and bring you to feel this as "palpitations". If you ran a home ECG using say an Apple Watch, Kardia or Wellue AI monitor (this latter would be useful as unlike the others it can detect atrial flutter itself), then you might see the the thuds were also being caused by "ectopic beats". These are beats that arise a little too early, and are followed by a slight delay till the next beat comes in. This means a little too much blood is in the atrium causing the valves to close a little harder than usual, hence the "thud" feeling. The heartbeat we feel isn't the heart beating itself, rather it is the heart valves closing.
All-in-all, I suspect you will, like me, be put on the waiting list for a cardiac catheter ablation, which, because the catheter is introduced into the heart from the vein in the groin, arrives in the heart on the right hand side, where the flutter is happening. This makes is a much quicker and safer procedure than that required for atrial fibrillation. Before that, you might be given an electrical procedure called a cardio-version to shock the heart back into normal rhythm, and you'll definitely be given a heart scan called an echo cardiogram to look at the various structures of the heart and to measure its output (called EF or ejection fraction).
Overall, though, relax as much as you can since the chaos going on upstairs has no really detrimental effect on the downstairs. Life goes on, much more stressfully, it has to be said, but your heart is safe and the treatments help a lot. Even if your mind keeps telling you that some kind of awful disaster is around every corner, which mine did thanks to my overactive mind, and which is an effect of anxiety, it truly isn't. You will be fine.
Kardia detects and identifies AFlutter but if mixed AF & AFlutter as I often had will analyse as AFib although it was really easy to see the runs of AFlutter amongst the AF. Is the Wellvue similar?
My Kardia never did identify it, so that's interesting as I read that it should, as you say. My doctor told me it is not easy to pick up and is easily masked by AF. He said it needs a 12-lead to detect it and even then it can be difficult. In my case, I recall the doctor injecting, if I recall, adenosine (?), to stop my ventricles briefly to allow the AFl to show.
The Wellue device claims to be able to identify flutter, and on the summary report it produces, there is a separate category for "%age atrial flutter". I no longer have this arrhythmia, however, since my ablation, so it is not there to be picked up. It's a clever device, though, and I would recommend it to anyone who has more than straightforward AF. Much of my days are troubled by heavy palpitations, for example, rather than AF, and I find it helpful for separating the two as the feelings both give re broadly similar.
Now you've mentioned it, a friend has just started with Afl, so I might ask him to try the Wellue out.
Thanks to everyone - lots of great tips and (best of all) reassurance that's it's not yet another big and scary thing to worry about!I am truly grateful for all the help, advice and support from everyone.
I have a Norfolk beach which is my mental refuge when I need to calm and focus, so I'll be envisaging that more often, fibnum. My husband is a runner, and I'll be nicking his recovery drinks, Squidgybod.
Just knowing I'm not about to tip over into another AF is helpful in keeping me less stressed, which should hopefully lead to less thudding times!
I had the very same experience when l was first diagnosed. It is a great shock at first. My anxiety at this time was through the roof, which of course, made everything much worse. If you have been diagnosed and checked at the hospital then all these feelings will be ok. You should be referred to a Cardiologist in due course, who will probably do more tests and discuss things with you. In the meantime try to relax as much as you can and remember it is not life threatening.
Once you have had the tests mentioned and reassurance that your condition is controllable then you will start to relax. Most of us have had A/F for a number of years now, 20 odd for me, and we learn to live with it, to know what to worry about and what not. Try and relax, listen to music, without. thumping bass I hasten to add, read a book, anything in fact that has a soothing quality. I played in a brass band lol so difficult at times but I know that other peoples loud music, emphasis on the bass, did in fact cause me problems. Good luck with your journey x
Unfortunately it comes with the territory ,at least with me. Having been a good club cyclist to i have become rather excersise intolerant. Have tried diff tablets and even have a pacemaker which has helped. It was originally put in with intention of av node ablation but after pm inplant was considered brst not to do ablation. Sorry if it doesnt sound encouraging. Im 81 jow so i guess i have to lrarn to accept certain changes but i still look for answers. Thats why wr are all on here i guess
Best advice is to keep your Doc informed of any changes or anything that your concerned about. By doing this he can treat you to the best of his knowledge. It’s worth knowing that if you were recommended for an ablation that A fl is the easiest and with the best success rate. I believe the right magnesium supplement may be beneficial with little risk of side effect, potassium supplement may also be beneficial but too much can be dangerous so watch this one, I would not recommend without Doc advice.
How often are they occurring & are they only happening when you are doing anything in particular? Sometimes certain foods or drinks are triggers & sometimes certain events cause 'thuds.'
I do sympathise. I also get this and think my heart is going to jump out of my chest, but there isn't usually a problem but it can be frightening. Try not to stress (easy to say, as I'm the world's worst stresser with AF) but you will get more used to it over time. I did actually go down the private cardiologist/electrophysiologist route and it was money well spent, as he had taken a lot of time to explain the electronics of the heart and is monitoring me closely. Good luck and great that your BP, etc. is normal.
Having my first atrial flutter with RVR 2:1 especially for hours is like the average person running full force in the worst elite marathon and it taxes your body (and mind) for many days later. I have afib/flutter but present 90% of the time with flutter (on 12 lead ecg) and even a week after my first flutter event (and back to sinus rhythm) I had strong heartbeats and thuds. I even went back again to hospital over a week after my first event with another racing heart. The hospital 12 lead ecg indicated sinus rhythm. I left the hospital feeling "defeated" and exhausted. But this did teach me how palpitations and heavy ectopic and thuds and quick heartbeats can be mistaken for flutter/afib. It takes time with many learning experiences on how the body presents and the mind copes. And it also took 3 weeks for the calcium channel blocker I was given to kick in. It's amazing to read how we are all similar yet also different.
My first flutter was two hours, the next was three - I agree that's it's exhausting as well as frightening. Only diagnosed on Monday, so the L-plates are still firmly on - hence the worry over the thuds. Hope you're settling into a better rhythm (in all senses) now.
Yes I have settled into a much better (sinus) rhythm (with the odd ectopics) and it's now a year and a half later. The best advice I was given was to educate myself on flutter/afib and all the medical options treating. Lifestyle also factors in.
PD63 has a point . The thuds we get are probably being caused by the meds. So maybe its a choice. Side effects or flutter. I sure dont like the flutter myself. Ive been affected for 6 yrs now and still trying other ways of coping. We are all after the perfect pill i guess.
Hello, I battled constant A-fib for17 years and found respite with Tikosyn for about 6 years then it quit working so I finally "pulled the trigger" as it were and got an ablation because cardio versions did not work for more than 3 days. 6 months and going strong with normal rhythm. Went into atrial flutter for several months after Tikosyn quit on me. In all that time I never felt thumping unless I was very active. If it bugs you I would recommend an EKG. Blessings - Gary P
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Worried about heart rate
Flutter and Heart beat
Heart muscle not working properly 
Alternating heart beat
Random heart rate spike but no missing beats 
