Afib, Aflutter, PVC's, Ectopics or what?

Hello All,
I was very active here about 10 years ago when I had a bout of afib. After a month or so I cardio converted on my own while getting a massage and have more or less remained in NSR until recently when I found out I was in aflutter. I am a 72 year old male, Vietnam veteran service connected for ptsd. I have had heart "issues" for 40 years. Would often have ectopic beats and PVC's ............sometimes pretty serious. Doctor's could never find anything wrong with my heart. Had worn a Holter monitor many times which never showed anything. Rushed to ER 35 years ago with a racing heart and panic attack. Doctor called it the "Vietnam syndrome." Many years ago a psychologist said I had "Soldiers Heart." The latter being a veteran that has heart issues but no physical reason to explain the heart issues. In other words, ptsd which causes the problems.
Last week I was cardio converted for the a flutter and it appears to have initially worked. However it appears I may be in and out of normal sinus many times a day. I don't understand how this is possible. I purchased Kardia EKG unit online recently and have used it daily for a few weeks. The readings are crazy. I can do it and the result is "possibel a fib", then a minute later I do it again and it says "Unclassified", then a minute later and it says "Normal." I sent one reading to the Karida doctor (for a fee of $10) and he/she stated I had brachycardia. My Omron blood pressure cuff shows "irregular heartbeat" on a reading and then two minutes later it says normal heartbeat.
Is it possible to be in and out like this?
Cheers,
Robin

I've frequent ectopics, short runs of afib (sometimes with flutter intricated) or of atrial tachycardia. My ECG device shows various interpretations which may be right or wrong. Showing the tracings to my cardiologist is far more reliable...
Keep in mind that even professional 12-lead ECG machines give unreliable "automatic" interpretations. My cardiologist told me not to bother with those crazy things written by the machine.

Two ER doctors once told me that my ECG showed atrial fibrillation. When the EP consultant saw it he said it wasn’t AF, just runs of ectopics.

It needs an expert to interpret the results correctly

Gill

Thanks for your comments.
I guess I would be better off not paying attention to the blood pressure cuff or the Kardia EKG thing. I'm driving myself crazy eh?
I take my heartbeat at my wrist. Sometimes it is skipping around and then 10 seconds later I detect a steady normal pulse for a minuter or more. It looks like I'm in and out all the time which seems pretty bizzare does it not?
Cheers, Robin

I'm guessing, in your situation, you'd need a Holter, interpreted by an EP, to get a really good handle on what is happening.

This cardiologist days that the Kardia had changed his practice for the good. Maybe get an EP and send him your data.

[theskepticalcardiologist.com]

The Kardia device is great for capturing persistent rhythms. It's not the best tool for capturing ectopics or really short runs of flutter or a-fib. As GeorgeN said, you really need to wear a Holter monitor for a day or two and let the cardiologist or EP take a look at that data.

Yeah, using a Kardia to capture fleeting moments that occur at random is very difficult. In 2015 I developed flutter. The episodes always felt very irregular when they began but within seconds they became regular, as is typical for flutter. I suspected it was afib triggering the flutter, but to be sure I had to capture the beginning of an episode. It took me months to do that, and when I finally did it was purely by chance.

Like George and wolfpack said, a Holter monitor is the way to go.

Will someone explain the differences between afib, flutter, PVC's, PAC's and ectopics? Do all impact circulation? I was successfully ablated 12 years ago, but have had three breakthroughs of something, each lasting a few hours, but years apart. Felt like afib but my heart rate was only in the 90's, not 180's like before. There was shortness of breath when active (windsurfing), similar to afib, but was it afib? Each converted on their own.

I am not looking for detailed explanations, just how each impact circulation. I know what afib does, but the others???

Quote
Ken
Will someone explain the differences between afib, flutter, PVC's, PAC's and ectopics? Do all impact circulation? I was successfully ablated 12 years ago, but have had three breakthroughs of something, each lasting a few hours, but years apart. Felt like afib but my heart rate was only in the 90's, not 180's like before. There was shortness of breath when active (windsurfing), similar to afib, but was it afib? Each converted on their own.

I am not looking for detailed explanations, just how each impact circulation. I know what afib does, but the others???

No way to know what you experienced, but it was probably afib or flutter. PVCs, PACs and ectopics in general don't generally cause shortness of breath. To answer your question....

Afib - your atria are beating in a chaotic, uncoordinated manner. There is no effective atrial pumping, so you lose the "atrial kick." It frequently also leads to a rapid ventricular rate (ie, your heartbeat), but not for everyone. It will produce an irregular heartbeat in pretty much everyone. Having a normal heart rate during afib is common, but having a very fast one is even more common. Afib produces symptoms ranging from minor ones like simply feeling palpitations to major ones like shortness of breath and syncope (fainting).

Flutter - Flutter is similar to afib but unlike afib it almost always produces a regular heartbeat. It can produce a very rapid heart rate, even over 200, but not for everyone. Like afib, some people experience flutter but still have a normal heart rate. Unlike the complete chaos of afib, flutter is caused by a single impulse traveling around and around in a circle in one of the atria. It's self-propagating. The single impulse just keeps circling around repeating itself. It has all the same symptoms and risks as afib.

Ectopics - Ectopic beats are beats that are out of place and don't originate in the sinus node, like all normal beats do. They happen because heart cells have a thing called automaticity, which means they can fire on their own. This is normally a good thing that helps keep you alive, but when it happens too often, it becomes a problem. Ectopic beats can trigger afib or flutter.

PVCs - Pre-ventricular contractions are ectopic beats that originate in the ventricles. Everybody has them but normally just a few per day, which they probably don't even notice. They're generally harmless and only when they become too frequent are they a problem. PVCs that occur in response to exercise can be a sign of heart disease.

PACs - Pre-atrial contractions are ectopic beats that originate in the atria. Not everybody has them but almost everybody with afib or flutter does. For people with afib, most odd beats they feel will be PACs. Like PVCs, they're generally harmless but if they become too frequent they can be a problem.

Hope this helps clarify.

Carey,

Thanks for the detailed information. I guess my episodes are likely afib since the irregular pattern and reduced blood flow are there. Checking my pulse during the three episodes that surfaced in the last 12 years, felt just like it did before my ablation, just at slower rate, plus they lasted a few hours each.

Hopefully down the road, the afib won't happen very often.

If you could feel an irregular pulse and it lasted more than just a few seconds, that was almost certainly afib. With only three episodes in 12 years I would strongly suspect dehydration and/or a temporary electrolyte imbalance.

My post-ablation AF episode earlier this year was also only a few hours, had a low rate, and was quite comfortable. If I hadn’t known anything about AF, I would’ve ignored it.

Hello All,
I'm back from a lovely Mississippi River Cruise. While away I assumed I was in NSR. A visit to my cardio guy last week proved differntly. He said I was back in a flutter. He asked me when it happened. As I do not have any symptoms I told him I had no idea. He thought it odd that I don't have any symptoms. He schedlued me for an appt with a local EP and told me an ablation might be in order.
A few days later I had my annual exam with my VA doctor. He reviewed my latest EKG and blew my mind when he told me the following:
First line of your EKG shows a flutter, second line shows NSR, third line shows a fib, fourth line shows ectopics. Next line shows NSR again. I said, "what the hell is going on?" and "why didn't my cardio Doc tell me this." He said, "Your cardiologist probably didn't want to get into it with you and he probably didn't have the time to explain in any detail because he probably sees 30 patients a day." I was dumbfounded.
VA Doc then tells me I probably have had this heart "issue" all my life and the reason I'm having problems now is due to the aging process. I'm 72.
Bottom line................Omron cuff says normal heart rhythum, Kardia says normal Ekg. My bp is about 135/85 and my pulse is averaging 60.
I have zero symptoms other than fatique but I'm thinking my age may be the cause of that. VA doc says I should stay on Eliqus. But, what doctor wouldn't say that?

The craziness continues.
I honestly don't know what I have. Last month EP gave me an EKG and told me I was in a flutter. Scheduled an abalation in Glens Falls Hostpital. North of Albany, NY. I went to see him last Friday and he says I am now in afib. Can't do ablation for that locally so will have to go to Albany for that. I am in line for a Dr. Natale ablation in the spring. Local EP wants to do a cardioconversion on the 17th of this month.
Here is what is absolutely crazy. Yesterday Kardia app showed "possible afib" several times with a pulse of 40-50. One reading showed a pulse of 38 which scared me to be honest. Omron cuff showed good bp but pulse of 40, with irregular heartbeat.

Today 4 Kardia readings showed normal with a pulse of around 75. 3 Omron readings showed good bp with a pulse of 75 with NO irregular heartbeat.

I don't feel any different physically from yesterday to today.

I would guess I am in NSR today but don't know for sure. Who knows what tomorrow will show. I think this has been going on for decades.
Is the Omron cuff a good indicator of NSR if the irregular heartbeat light in NOT lit?