AFIB versus AFLUTTER

[richm66]

I have a question if someone is willing to shed some light on.

I have been a PAC sufferer for many many years. Controlled by Inderal and now just taken as needed, as I have finally convinced myself not to worry about the.

On Monday - of this week, I felt my heartbeat doing something totally different and on my Apple Watch extremely high for me (100, back to 80 back to 55 back to 90 within seconds).

I went to the ER for this as it was very new and unusual.

I had an EKG and the computerized auto diagnosis from the printout stated Atrial Flutter. After having blood work and speaking with doctors on staff (intern and attending) - they showed me a "sawtooth pattern" that was indicative of Atrial Flutter and that I was throwing off PACs and PVCs.

After consulting with my Cardiologist, I was sent home and had an appointment with him the next morning. An EKG pattern was repeated in his office and he showed me the same saw tooth pattern.

After examining me and discussing options, it was agreed that I would be put on a blood thinner and scheduled for a TEE and Cardioversion on Friday of this week. He actually was ok with skipping the TEE to check for clot (because he felt risk was so low) - But I kind of insisted just to be safe.

At the end of the appointment, he studied the EKG again intently and made the comment that it looked very interesting. He then said he was "not so sure that it actually wasn't AFIB instead".

I know that Flutter typically presents with a "sawtooth pattern" but is felt in the pulse as just a fast regular beat. However, my pulse is irregular and fast. it is sort of a few fast beats, a pause or so, some more fast beats, etc.

In any event, the ER docs wrote up that I had Atrial Flutter with PACs and PVCs. I called the ER back and asked what was in their ER notes for my case and the triage nurse confirmed that the doctors wrote up diagnosis as AFlutter and did not just base it just on computerized printout but examined the EKG (assumed based upon their expertise).

I did do some research that stated that there are instances whereby Atrial Flutter can be irregular (not as common). And I did read that the "sawtooth" pattern is a classic symbol of AFlutter.

I am probably doing way to much thinking on this , but I have read that Flutter can usually be treated long term more easier than AFib (less medications, easier ablation because of location in Atrium, etc).

I am very OCD about health and was curious if anyone had any comments that they could provide. I would like to think the ER docs were very thorough (it was a large city training hospital trauma ER) and that the cardiologist, while being more of the expert here was maybe intrigued by the irregularity of the beats (which is usually a sign of AFIb).

I am nervous about the TEE and Cardioversion, but he told me he has done a lot of these and almost all are very successful at getting back to normal sinus rhythm. Sorry for such a long post. Thanks for any help.

[Belge du sud]

I experienced both right a-flutter and A-fib two years ago. They Can trigger each other, so I don't find surprising your flutter could have been somewhat irregular. I'm no specialist, but I wonder if A-fib is so obvious on an ECG tracing when intricated with a-flutter.
I've been ablated for both problems. Catheter ablation for flutter is highly efficient and at low risk. Drugs, conversely, have low efficiency on flutter.
I'm still having A-fib, but a-flutter is definitely a thing of the past.
Unhappily, it seems that A-fib is more likely triggering flutter than the opposite.

[venusbluejeans]

To be completely honest, I have no idea what you are talking about.... To me a PAC is a code you need to swap mobile phone suppliers.

Maybe at least once in your thread you could put in brackets what the initials of the acronyms are?

[Belge du sud]

Sorry. Such acronyms are widely used on this part of the forum, so we rarely feel the need to type the complete names.

PAC stands for Premature Atrial Contraction.
PVC for Premature Ventricular Contraction.
A-fib = atrial fibrillation.
A-flutter = atrial flutter.
TEE = transesophageal echocardiography.

All those things are awful, especially the last one , but A-fib and A-flutter are potentially harmful.