Update on Tachycardia

Last week my heart rate was fast and I was searching for the cause, blaming it on MSG or whatever.
It's still fast, and after having an EKG, I now know that it's atrial flutter and will be scheduled for cardioversion. After over four months of perfect NSR since my ablation, it is kind of a let down. But I guess flutter can often be an unexpected visitor after ablation. Now I'm starting to get nervous about the cardioversion, as I've never had one except during the ablation. Any advice on how to get mentally ready for a cardioversion?

I may have had the record of 52 cardioversions. It isn’t terrifying or anything. An anesthesiologist comes in and gives you a push in your IV and you are out. It doesn’t last long and after 30-60 minutes after you quickly wake up you go home. You just can’t drive for 24 hours and they prefer you have someone pick you up instead of calling an Uber. I always get the Uber. It’s not frightening at all and you will be back in calm nsr. My only glitch is occasionally getting a burn mark. I know my joules that will convert me and propofol is my anesthesia of choice.

You will be fine.

I agree with Susan. I don't come close to holding any sort of records here, but I've had something like maybe 15 cardioversions. It's a quick, safe, simple procedure and there's no reason to be nervous about it.

I only have had one CV, and it was unsuccessful. However, as others are describing, it's just another three minutes on the gurney with masked people hovering over you and making you sign waivers. You'll suddenly hear voices, you'll soon realize you're back with the Land of the Living, and you'll get immediately debriefed on the outcome.

Depending on the dosage, and their weight estimate/record of your body mass, they may over-drug you slightly or under drug-you. The latter happened to me and I regained the 'hearing voices' level of consciousness just as the third of three permissible jolts was issued by the technician.
I wouldn't call it the best experience of my life, but I lived.

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gloaming
Depending on the dosage, and their weight estimate/record of your body mass, they may over-drug you slightly or under drug-you. The latter happened to me and I regained the 'hearing voices' level of consciousness just as the third of three permissible jolts was issued by the technician.
I wouldn't call it the best experience of my life, but I lived.

Here is moderator Shannon's post from 10 years ago with a similar experience. The over-drug option seems to be preferable IMO: [www.afibbers.org]

Unsuccessful ecv’s happen. Two times I had an inexperienced fellow administrator the ecv. They didn’t place the pads correctly. I swear they nearly covered near my navel. Now I micromanage them. I do my own checklist and have them check if the machine is set to sync and not defibrillation. That happened once and I saved myself from iatrogenic harm. I also have a say on pad placement and how many joules. 150 is overkill. I also suggest them to load the syringe to 75 propofol and push accordingly because my target knockout is between 40-60. I tell them when I’m knocked out my eyes remain open so listen to my chatterbox. I tell them once I’m finally quiet to zap me…and I start counting until I’m unconscious.

I have to have a tolerant er doctor. They usually smile because of the number of ecv I’ve had, I know what works.

Can I ask how fast your heart rate was and for how long to need cardioversion? thanks

Thank you all for your information and encouragements. Those are impressive numbers of cardioversions!
My heart rate has been pretty consistent for a week, running around 125 at rest to 135 with activity.

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GeorgeN

Depending on the dosage, and their weight estimate/record of your body mass, they may over-drug you slightly or under drug-you. The latter happened to me and I regained the 'hearing voices' level of consciousness just as the third of three permissible jolts was issued by the technician.
I wouldn't call it the best experience of my life, but I lived.

Here is moderator Shannon's post from 10 years ago with a similar experience. The over-drug option seems to be preferable IMO: [www.afibbers.org]

Thanks for the link. I have to confess to laughing...some...because my experience was quite similar. I was just beginning to come out when I got that massive, and painful, jolt. I moaned and heard myself say aloud, 'OOhhh, that's painful.'

"Oops, sorry...." and for the next three minutes, I swear, my pectoral muscles rippled and I felt like I was shivering badly. And, it didn't work to boot.

If you are asking me in particular this question, I get very symptomatic at 150-200 hr. 170-200 the ER usually converts me and I was sent to iCU the past three times because my troponin was either high, very low BP, hypoxia or I met the criteria to be in the icu. I don’t run to the ER with every arrhythmia. I spent 29.5 hours home recently in 134 flutter because I wasn’t symptomatic. If it was longer I would had gone to the ER once my ankles swelled up. I should had gone that time. Yesterday and today my heart is nonstop aggressive either with very numerous short runs of 124 that my pacemaker converts or long runs of 84hr Supraventricular Ectopy (according to Kardia). I’m just waiting it out at home for now checking my ankles for edema (yep) after numerous urine dumps (big pee) that this forum calls it.



Edited 1 time(s). Last edit at 11/08/2022 06:23PM by susan.d.

You know one thing that makes your heart rate increase? Low blood volume, and low blood volume is caused by dehydration from any cause. So those of you who experience the Big Pee need to replace that lost water. Your kidneys are being lied to by your atria, which can produce excess ANP during afib and flutter. ANP tells your kidneys you have too much water, so you need to consume fluids to overrule the lie your kidneys are being told. Drink as much water as you think you're peeing beyond normal.*


* If you've been diagnosed with heart failure or kidney disease, consult your doc first.

Thanks Carey

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Carey
ANP tells your kidneys you have too much water, so you need to consume fluids to overrule the lie your kidneys are being told. Drink as much water as you think you're peeing beyond normal.*
.

Not that I have this issue, but wondering if a person drinking the extra water should add in some electrolytes (sodium, potassium, magnesium)? Seems like a lot of extra water would dilute them.

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GeorgeN
Not that I have this issue, but wondering if a person drinking the extra water should add in some electrolytes (sodium, potassium, magnesium)? Seems like a lot of extra water would dilute them.

Yeah, probably so if it's a lot of additional water. Just substituting juices or coconut water for some of the plain water would be more than sufficient, I would think.

Thanks George! I’m adding electrolyte powder to my water.