Atrial Flutter Surprise

[TellTaleHeart]

So there I am, minding my own business 10 days post discharge, when I try out my new BP cuff, one that highlights pulse anomalies. Resting HR is sustained 130+. Whoa! Didn’t really feel like my heart was pounding it’s way out, no shortness of breath beyond “expected“ 10 days out, maybe a little more tired. Called my PCP and told him, who then called me in for an ECG. He consulted with my cardiologist, and they decided to get me to the ER since I had had OHS so recently. Dang!
Got admitted and learned a new term: Atrial flutter. I was told it can happen to around 30% of post-operative OHS patients. Over the course of several days they tried medicinally getting it back to proper rhythm, with no sustainable effect. They finally, in combination with TEE scope monitoring, sent me down for cardioversion which zapped me back into sustained proper sinus rythm at around 75-80 BPM. Home again a couple of days later, with surprisingly way more energy. Just a bump in the road.

 

[egar]

I had atrial flutter a few times just before and right after my mitral valve replacement. Once it was controlled with amiodarone. The other two times I was cardioverted. In those flutter sessions, my heart rate would be 150-160 bpm for hours. About 3 months after surgery, I opted for ablation to address the flutter and that fixed it. It was a simple, outpatient procedure. It's been three years now and have not had flutter since. If you find you flutter recurs, talk to your cardiologist about ablation.

 

[TellTaleHeart]

I had atrial flutter a few times just before and right after my mitral valve replacement. Once it was controlled with amiodarone. The other two times I was cardioverted. In those flutter sessions, my heart rate would be 150-160 bpm for hours. About 3 months after surgery, I opted for ablation to address the flutter and that fixed it. It was a simple, outpatient procedure. It's been three years now and have not had flutter since. If you find you flutter recurs, talk to your cardiologist about ablation.

Thanks Egar, the subject of ablation came up in convo with cardiologists. Who knows, it may be in my future too. Reassuring to hear you describe it as “simple“.

 

[pekster11]

So there I am, minding my own business 10 days post discharge, when I try out my new BP cuff, one that highlights pulse anomalies. Resting HR is sustained 130+. Whoa! Didn’t really feel like my heart was pounding it’s way out, no shortness of breath beyond “expected“ 10 days out, maybe a little more tired. Called my PCP and told him, who then called me in for an ECG. He consulted with my cardiologist, and they decided to get me to the ER since I had had OHS so recently. Dang!
Got admitted and learned a new term: Atrial flutter. I was told it can happen to around 30% of post-operative OHS patients. Over the course of several days they tried medicinally getting it back to proper rhythm, with no sustainable effect. They finally, in combination with TEE scope monitoring, sent me down for cardioversion which zapped me back into sustained proper sinus rythm at around 75-80 BPM. Home again a couple of days later, with surprisingly way more energy. Just a bump in the road.

i had atrial flutter around 2 weeks after my valve replacement.
heart beat was ~140 bpm...didn't feel that bad either
went to A&E and spent 3 nights in the cardiac ward..was given digoxin and betablockers (still on them) to calm down my heartbeat (got it to ~90-100 bpm at rest)
2 months later i was cardioverted and normal rhythm resumed ..nearly 4 months later all OK on that front

 

[pekster11]

So there I am, minding my own business 10 days post discharge, when I try out my new BP cuff, one that highlights pulse anomalies. Resting HR is sustained 130+. Whoa! Didn’t really feel like my heart was pounding it’s way out, no shortness of breath beyond “expected“ 10 days out, maybe a little more tired. Called my PCP and told him, who then called me in for an ECG. He consulted with my cardiologist, and they decided to get me to the ER since I had had OHS so recently. Dang!
Got admitted and learned a new term: Atrial flutter. I was told it can happen to around 30% of post-operative OHS patients. Over the course of several days they tried medicinally getting it back to proper rhythm, with no sustainable effect. They finally, in combination with TEE scope monitoring, sent me down for cardioversion which zapped me back into sustained proper sinus rythm at around 75-80 BPM. Home again a couple of days later, with surprisingly way more energy. Just a bump in the road.

very similar experience to what i had
i was also around 2 weeks post op when it happened too
cardioversion seems to have done the trick

 

[TellTaleHeart]

i had atrial flutter around 2 weeks after my valve replacement.
heart beat was ~140 bpm...didn't feel that bad either
went to A&E and spent 3 nights in the cardiac ward..was given digoxin and betablockers (still on them) to calm down my heartbeat (got it to ~90-100 bpm at rest)
2 months later i was cardioverted and normal rhythm resumed ..nearly 4 months later all OK on that front

I was sent home with Warfarin prescribed, hopefully for short term only, and Verapamil. Following up with cardiologist next week. So far resting pulse maintaining at 75 - 80. Blessed with interesting times!

 

[Mister_James]

This is the surprise those who think tissue valve replacement saves them from warfarin. Atrial flutter or Afib depending on frequency will get you on warfarin.
Dilated atrium because of a muscular heart, will get you arrhythmia and what do you know...those dang pills.
I have a vagal triggered paroxymal afib. I just have to chug a cold slushy, cold beer or water and I trigger afib. Lasts a few hours, longest was about 2 days. I have had medical conversion but not yet shocked.

 

[pellicle]

This is the surprise those who think tissue valve replacement saves them from warfarin. Atrial flutter or Afib depending on frequency will get you on warfarin.

I know I'll send the wrong message by clicking like, because I don't like this truth. It is none the less a fact, and one I bring up from time to time. IIRC about 10% of patients.

Then there is the increased risk of requiring a pacemaker in reoperation. I'm really pleased that after 3 OHS I avoided that one.

 

[TellTaleHeart]

Yep, the chance of needing a warfarin regimen at least temporarily post-surgery had been described to me by the surgeon. My circumstance - primarily my age (68) and a genetic predisposition to colon cancer that would warrant frequent colonoscopies - guided me towards a bovine valve. While I admittedly would be disappointed if warfarin became longer than a temporary need, I’m still comfortable with that choice. As many on this forum have demonstrated, life with anticoagulants is manageable and nothing to be feared.

 

[TellTaleHeart]

I am happy to report I am no longer on warfarin! Six months since valve replacement and five months since Aflutter episode (the reason for my warfarin prescription in the first place) my Cardiologist had me wear a stick-on heart monitor for 2 weeks to prove I was no longer experiencing irrythmia, which I hadn’t noticed since cardioversion 2 weeks post surgery. No signs of any a-flutter / a-fib. Off warfarin I go! Continuing with verapamil, losartan and baby aspirin daily. He gave me a 5 day sample of eliquis as a “pill in a pocket “ to have in an emergency if a flare up should reoccur and I couldn’t get to medical services right away.
The 5 1/2 months I was on warfarin wasn’t much more than an inconvenience for me, except for the worry about bleeds, internal and external, but I am glad to be off it.

 

[pellicle]

glad things are back to normal

 

[Chuck C]

I am happy to report I am no longer on warfarin! Six months since valve replacement and five months since Aflutter episode (the reason for my warfarin prescription in the first place) my Cardiologist had me wear a stick-on heart monitor for 2 weeks to prove I was no longer experiencing irrythmia, which I hadn’t noticed since cardioversion 2 weeks post surgery. No signs of any a-flutter / a-fib. Off warfarin I go! Continuing with verapamil, losartan and baby aspirin daily. He gave me a 5 day sample of eliquis as a “pill in a pocket “ to have in an emergency if a flare up should reoccur and I couldn’t get to medical services right away.
The 5 1/2 months I was on warfarin wasn’t much more than an inconvenience for me, except for the worry about bleeds, internal and external, but I am glad to be off it.

Great news! Thanks for the update and for sharing your experience.

 

[Iceman331]

Amazing! I wish you so much continued health and happiness.