Still feeling flutters

Hi all. Recently had pacemaker fitted due to atrial flutters.

Been back to hospital once as had an electric shock. They changed the settings.
I am still getting the flutters though but nothing severe as before. Is this normal? Is it that the pacemaker kicks in once the flutters begin.

Ivor

2 Comments

Check reason for pacemaker

by Theknotguy - 2016-01-08 02:01:49

I feel you'll want to check with your doctor about the reason why you got the pacemaker. A pacemaker can't do anything about afib or atrial flutter. The pacemaker will make sure your heart will beat and keep your heartbeat to a normal level.

In my case, if my afib is untreated it causes my heartbeat to go faster and faster until it kills me. When they gave me drugs to slow my heart and prevent it from going into afib, it stopped beating. So I was between the proverbial rock and a hard place. Goes too fast, goes to slow. Either way I'm dead.

Doctors implanted the pacemaker. If the drugs to slow my heart cause it to stop or slow down, the pacemaker steps in and brings my heart rate up to a normal level.
The term for what they did with the pacemaker and medications is called Rate Control. There is also a Rhythm Control but I don't know anything about it.

My pacemaker is a Medtronic Advisa which has an additional feature called APP (Atrial Preference Pacing). This feature monitors my heart and if I go into afib, it will increase my heart rate to mitigate afib. Sometimes it stops my afib, sometimes it doesn't. I can tell when APP is working because I get "hot flashes". You don't say in your bio what pacemaker you have so I don't know if you have APP or the newer version called Minerva.

In answer to your question, yes you can continue to have afib and a-flutter. It can become worse enough that you'll need to have an actual physical ablation. Hopefully it can be controlled by medications such as Cardizem, Sotalol, Metoprolol, and others - which are called chemical ablation. But there's no guarantee the medications will work, or work for a long time. Even if you do have APP or Minerva, your afib, a-flutter can continue to get bad enough for you to need a physical ablation.

You're in the UK so hopefully you can get to your doctor's office and get an explanation of what they are doing for you. I'm not sure of the ins and outs of the UK medical system so can't advise you as to how you would go about finding out. I do know the UK has a good heart association. Perhaps that would be a route for you?

The good news is there is a lot that can be done for those of us with afib. Medical science is advancing on both the pacemaker side and the medication side. Obviously not as good as we'd like, but twenty or more years ago there wasn't too much they could do and, in a lot of cases, people would just die.

In my case, once I knew how they were treating my heart condition, I was able to work with my doctors to improve my situation. Hopefully it will be the same for you.

I do hope you can get some answers and that you will have minimum problems adjusting.

PM and atrial flutter

by Selwyn - 2016-01-09 05:01:50

The PM does not control atrial flutter or fibrillation.
Atrial flutter will drive your heart at about the rate of 150 beats per minute (bpm), atrial fibrillation at 120 bpm.
The flutter being more readily felt ( if seems to cause me to vibrate in bed!).

For a dual lead PM, the PM stops sensing the atrial activity when if gets to such high levels as fibrillation and flutter, and senses the ventricular activity ( this is shown on your print out under AMS, atrial mode switching, ie. it switches over to the ventricles). The pacemaker, as you put it, 'kicks in", yes! There is nothing normal about atrial flutter or fibrillation- both conditions cause medical complications, hence need to be treated.

What is causing your palpitations?
Best to get an ECG done, either when you have the 'flutters' or a 24-48 hour monitor ( ambulatory ECG).
Only the ECG will tell you what is happening.

I had a flutter ablation ( thank you NHS) as I wished to stay on Flecainide for fibrillation, and Flecainide can cause flutter! No further flutter.

Selwyn

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As for my pacemaker (almost 7 years old) I like to think of it in the terms of the old Timex commercial - takes a licking and keeps on ticking.