Wait it out, go to ER, try PIP or what ?

I have a Kardia 6 Lead.
I got overheated this morning & I've had what I THINK is flutter since 8:20 a.m. HR has been in the mid 150s. I tried a bunch of interventions like cold pack, cold packs on feet, coughing hard, low sodium V-8, that blowing valsalva thing, I also had the urine dump a few times, and then decided to just keep very cool in front of the fan and with the A/C on, and wait it out until my morning meds.

Morning meds were at 11:30 (take with food): metoprolol extended release so once a day, Flecainide 100 mg (morning and evening), Pradaxa (morning and evening) and lisinopril (once a day).

There was a slight change after the Flecainide but then back to HR being 150. The HR of 136 at 12:55 was odd (after morning meds), since my HR went back up afterwards.

How long do I wait to hope I convert on my own?
Would taking half a Flecainide help? I do *not* weigh under 165 lbs.
Am I doing any damage with this "steady" HR in the 150s?
I'm attaching 4results from my Kardia today and have no clue what means anything except I see odd things in the readouts--are those artifacts?

Thanks for any help or hand-holding! Calling Kaiser would result in being transferred to at least 2 different departments before I have to wait for a call back from the Triage nurse, who would just tell me to go to the ER, where I'd have to wait until they can give me a COVID test (hope it's a rapid result one) etc.

The latest Kardia at 1:37 -- HR is 151 but looks steady to me--maybe no artifacts? I dunno. I don't even know if I'm attaching things correctly -- even with the A/C and fan, it's stinking hot in So Cal.
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other kardia readouts with odd little things in the lines:
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Feel better Sue! I hope you self convert.
Yeah, the heat is brutal here in So Cal!

Yeah, that's flutter. Flutter waves are clearly visible in aVF.

You can try a PIP, but flutter is often resistant to flecainide. It's better at preventing flutter than stopping it. But I'd give it a shot anyway. Just take an additional 200 mg with your next 100 mg dose. As for waiting, is the ER you would go to willing to cardiovert you? If so, I'd get up and go now. If not, I'd give the EP a call in the morning. It's not doing you any harm so there's no rush.

Sorry to hear Sue. My first event was the only one with higher heart rates. I didn't like it.

Hope you can kick out of it.

Thank you Susan, Carey, and NotLying! Please hold a good thought for me -- can't hurt, might help, ya never know!
Sue

Sue, if you weigh less than 154 pounds limit your flec to a total of 200 mg at a time, not 300 mg as Carey says (unless you've been told differently by your EP). This limit is standard. Susan.d was told differently when she weighed in the 120's and had a bad outcome.

It sound like you need a short acting rate-control drug on hand to slow down your HR during events. The metroprolol you have is extended release, you probably should have the short acting kind on hand, to help control your HR, at the onset of an event.

As for the Flecainide, it would be better to get your HR slower, before trying a high dose of the Flec. If you haven't tried PIP yet, you should titrate up on taking a big doses of Flecainide, like 150-175mg this time, then 200 next time, (at least a day or two later). Also this PIP method should be run by your EP Dr. before you try it, (if you haven't already). If it was me, this time around, I would only take a moderately increased dose of the Flec, and then probably head to the ER. Later you can sit down with your EP and get better prepared for the next time around.

If you do head to the ER, it would be better to wait until daytime hours. More experience Dr's are around, or available to be called, and they are more likely be willing to Cardiovert you if that is what you wanted.



Edited 1 time(s). Last edit at 08/24/2020 12:53AM by The Anti-Fib.

Thanks, George and The Anti-Fib!!!
Sue

Quote
GeorgeN
Sue, if you weigh less than 154 pounds limit your flec to a total of 200 mg at a time, not 300 mg as Carey says

Just as an FYI, I already knew she was over 154.