Did I Have Atrial Flutter last night? What caused it?

It's over 7 months since my Bordeaux ablation and so far very pleased with the results

However I had a very rough night last night. I woke up after about 3 hours and my heart started to race. I did the twist stretch which has been very successful in the past for reducing the pulse rate but even after 10 - 15 minutes there was no change. I relaxed and after a while the rate dropped to 80 - 85 and stayed there: about 20 - 25 beats faster than my normal.

This happened another 3 times, the last being my usual rising time. I sat up then to drink some water and the pulse dropped to 69. The heart has felt a bit fragile at times since then and the pulse is steady but about 5 - 10 beats faster than normal.

Was this A Flutter?

There were two recent changes in my normal routine. I started taking DLG ( which is generally accepted to be side effect free) on Friday; 3.4 grams before each of 3 meals for nighttime acid reflux.

And last night I gave up after trying for 2 weeks to sleep on my left side (which really helped with the reflux) because i found it so uncomfortable I was getting very little restful sleep.

Any thoughts on just what its was I had and what caused much appreciated.

Sam

That's why I own a personal 1-lead ECG monitor. On a lead2 tracing, the difference between a- flutter, SVT and sinus tach is relatively easy to see. And if I can't, my cardiologist will do.

Did you check your BP?

Licorice can be potent.

“However, licorice in its natural form contains a compound called glycyrrhizin that can raise blood pressure and cause other potentially severe side effects in some people. DGL stands for “deglycyrrhizinated licorice”. ... DGL decreases the symptoms associated with acid reflux from the stomach.”

Hi Sam, was this the first time you had taken DGL, or perhaps have you been taking it at higher doses for a while recently?

While Deglycyrrhizinated Licorice should be realitively safe, as Catherine suggested it could be that you may have had an adrenaline spike due to either excess black licorice content that (and I’m speculating here) was not properly or fully deglycyrrhized during production of that batch of DGL ... or perhaps your body is extra-sensitive to glycyrrhizin that is the part of black licorice that in excess doses (roughly 2oz. a day over a week or two) can cause a real jump in BP, and even potentially trigger an arrhythmia from a drop in potassium levels that can also lead to a spike in endogenous cortisol/adrenaline.

The other, more pedestrian explanation, of course, could be that you did have a run of Atypical Left Flutter subsequent to your index ablation. If so, then the odds are high at this many months past your blanking period that it will likely happen again. If it does, I suggest you contact your Nurse practitioner at Bordeaux and set up a touch-up ablation to address this left atrial flutter, which is not uncommonly needed after a more extensive ablation.

In fact, we know that dealing with a post index ablation atypical left flutter is often a necessary second ... and usually last ... step required in the ablation ‘process’ for durable freedom from all Atrial arrhythmia to be achieved, beyond just eliminating the AFIB manifestation of an overall more advanced atrial arrhythmia condition or disease.

If you do get any more flutter-like recurrances that are confirmed as atrial flutter, don’t procrastinate in gettting that addressed soon so that you can get on with your life free of all this lousy business.

And I, too, highly recommend you invest in a well-vetted single lead mobile EKG device such as the KARDIA mobile device. While not perfect, it has been much improved over the last few years and can save a lot of running back and forth to your EPs office and give you some peace of mind in at least knowing what you are dealing with in the moment.

Cheers!
Shannon



Edited 2 time(s). Last edit at 02/02/2019 10:41AM by Shannon.

Thanks for the replies, folks. I didn't check my blood pressure. I had not used DGL before. I haven't taken any today and it will be interesting to see what tonight brings.

I realised that another Ablation was quite possible but really, really hoped it wouldn't be needed.

As one who flies a lot, Shannon, you won't know what it took for me to get on that plane. My wife told me that she was convinced, right up to the time we on the plane, that I wouldn't be able to do it.

I have in fact flown many times in the past but my phobia steadily got worse until I promised myself in 2000 that I'd never fly again.

Where do you live Sam?

If not in Europe. then perhaps you can find an outstanding ablation expert EP/center relatively closer to home ( i.e. a distance conducive to driving/train or maybe doable with the help of a strong tranquilizer on a more modest duration flight with perhaps your wife handling on board baggage etc in the air??).

Shannon

Amtrak serves Austin.

I think Sam is in Ireland.

I live in N Ireland. No experts here. The nearest here would be in England - Professors Ernst and Schilling.

I didn't consider them initially because 1) their expertise doesn't compare with Bordeaux. 2) They both do PVI only on the first operation; Bordeaux do everything. 3) They monitor you for a day afterward; Bordeaux is 3 or 4 days with constant monitoring. 4) They were considerably more expensive than Bordeaux.

I tried a tranquiliser once before a flight and lost 2 hours. I was apparently still talking and moving about but slowly and I wasn't aware of anything. Cabin crew took me and my wife on to the plane first and put a pillow under my head. I became fully aware wondering how I got there as the effect wore off with the plane still on the runway due to a long delay.

UPDATE. I took no DGL last night and had one episode of fast beats. When I woke up again I checked my pulse and it was normal and has remained normal all day normal today.