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Arrhythmia Alliance
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Cardioversion for atrial flutter

Has anyone had cardioversion for atrial flutter, how long did it last before the symptoms reappeared. Any recommendations for the best medication or that to avoid. I know that we are all different but a concencus from a group like this is also very informative

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I had a cardioversion in April for Atrial Flutter. At first they weren’t sure if it was Flutter or SVT which I’d previously been diagnosed with. My heart had been 150 for a couple of days so I was admitted to hospital. They tried Adenosine (known as the impending doom drug) and my HR dropped momentarily to 80 then went straight back up to 150. They tried chemical cardioversion (not sure which drug) but that didn’t work so the next day they did an electrical cardioversion which did. The cardioversion last about 10 weeks then I went back into Flutter which then morphed into atrial fibrillation. I had an ablation for both 3 months ago. The flutter has gone it I’m still having some AF dramas.

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Thank you, very similar to me had SVT for 20 years, thought to be atrial tachycardia but now thought to be atrial flutterafter a 12 lead ECG detected it. What medication did they give you after the cardioversion.

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I was on Sotalol for SVT/MAT (Multifocal Atrial Tachycardia) when I went into Atrial Flutter so my dose was increased and I was put on an anticoagulant for 4 weeks. When I was first diagnosed with SVT I was on Verapamil and when that didn’t control things I was switched to Flecainide and then Sotalol. When I was diagnosed with AF as well my Sotalol dose was increased again - I ended up on 320mg per day. Two weeks after my ablation I was back in hospital and Digoxin was added as well. A month ago I was taken off Sotalol as it wasn’t controlling things any longer. I’m now on Amiodarone (200mg/day), Digoxin (187.5mcg/day), Atenolol (50mg/day) plus Rivaroxiban. It is still not completely controlled and the EP said he only wanted me on Amiodarone for a couple of months because of the toxic side effects with long term use. Will see what 2019 brings. I am over hospitals, doctors and drugs!

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Yes this is a very cruel condition and there is so much of it about. Personally I am devistated as I had thought Flecainide was the Miricle drug only to be told that it made things worst (I also was incorrectly diagnosed with MAT). Looking at numerous posts I get the feeling that an ablation normally works first time for flutter but you generally have to have at least 2 for most other arrhythmia. Clearly everyone is different and the best way forward is only known by the Cardiolgist (unfortunately the best way forward is not always the right way forward). Lets hope the medical community come up with improved ways to deal with this. Good luck (I think we all need a little luck to get the right treatment).

PS the drugs I am on are Digoxen, Bisoprolol and Riveroxiban

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I’ve been optimistic every time I’ve gone into the cath lab. I had 2 ablations for SVT, during the second one they discovered it was MAT. Then they attempted an AFluttter/AF ablation in early August but found a blood clot in my heart so had to abandon it. When I finally had it done in September, the EP was confident as he did a lot of burning and a lot of testing. Unfortunately my heart had other ideas and I ended up back in hospital 2 weeks later and developed pericarditis. It’s been drama after drama and I’ve been off work since June. I want to get my life back. I’m 54 so have a way to go before retirement.

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You've gone through the mill with all of that and it's good that your keeping your spirits up. Talking of spirits, I am convinced that alcohol or the way your body reacts to alcohol effects our condition, with me it is normally 5 to 10 days after just 2 units. I love a few glasses of wine but no more, thought it will be difficult over Xmas it's just not worth it.

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I agree. I cut back to the occasional drink 2 1/2 years ago when diagnosed with SVT then cut it out altogether when I had the atrial flutter in April. Everyone keeps saying “I bet you’re looking forward to having a drink again” but even if I get this all sorted I probably won’t drink- it’s just not worth it. I have found a few great mocktails and I often have my non alcoholic drinks in a wine or champagne glass so it’s a tactile experience and stops everyone asking why I’m not drinking.

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I must admit that I found stopping drinking much easier than expected. I have not found a good alternative to wine yet but there are a few OK beer alternatives (most are terrible). Try a good, long forgotten and old fashion drink of a long glass of non alcoholic larger and lime - quite palatable with savouries and nibbles.

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I had a magnificent Virgin Mojito (made with Ginger Beer) at a restaurant last week. I must see if I can find a similar recipe for Christmas 🍹

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I had ablation the end of August 2018 for Atrial Flutters. I'm still having issues with flutters. Does it never end? I'm now on Xarelto and flecainide after ending up in ER. It seems the flutters now go to A fib? I'm waiting to have another holter monitor test this Wednesday.

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Thank you for your reply, sorry to ear your still having such problems, hope you don't have to wait long for the ablation.

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Underwent cardiovert mid-August for instance of atrial flutter. Restored rhythm. After several weeks, no more medication. Have been deliberate about building up physical stamina. Occasional light headed-ness; however no where close to flutter incident which sapped energy ( image of air going out of balloon ). Now back to basketball and hiking. Though not pushing as hard as before. Cardiologist says a little flutter likely remains to be ablated. Much easier, he says, to address than afib ablation.

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Thank you for your reply, looks like a good degree of success with the cardioversion and you can live a relatively normal life again.

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Did you have a few funny beats or skips for a few days after cardivasion or were you back to "normal" and building up your stamina straight away.

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No skips or funny beats, as I recall. Just a seemingly very slow recovery

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