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Can flutter be paroxysmal?

Posted by MeganMN 
Can flutter be paroxysmal?
February 11, 2024 10:24PM
Sorry to keep picking your brains, but this is really the only source of really educated, firsthand knowledge that I have to pick from! Last night was pretty rough, and I caught this on the Wellue. I just can't decide if it looks more like artifact. The Diagnostic called it Afib, but it looks more like flutter. Can flutter be that paoxysmal? It lasted maybe 30 seconds.

Thanks again for everything, gang.

Edited 1 time(s). Last edit at 02/11/2024 10:37PM by MeganMN.
open | download - Screenshot_20240211-161851.png (152.7 KB)
Re: Can flutter be paroxysmal?
February 11, 2024 11:28PM
It definitely can, but flutter is a much more stable rhythm than afib so it tends to continue when left to itself. That recording you attached could be flutter, but it's a really short sample. What did you record it with?
Re: Can flutter be paroxysmal?
February 11, 2024 11:41PM
Carey, when I had my first ablation in 2021 they found unexpected paroxysmal flutter. That is what has me curious. It is recorded with a Wellue in Lead II. The first screenshot is the initial rhythm, then the second is when it changed. Same recording, not moving, laying down.

Edited 1 time(s). Last edit at 02/11/2024 11:57PM by MeganMN.
open | download - Screenshot_20240211-175457.png (215.8 KB)
open | download - Screenshot_20240211-175320.png (230.2 KB)
Re: Can flutter be paroxysmal?
February 12, 2024 04:22AM
Could definitely be flutter, but you're going to need a 12-lead to be sure. But if it's only lasting brief periods like 30 seconds I wouldn't worry about it much. That barely even meets the criteria for calling it a sustained arrhythmia.
Re: Can flutter be paroxysmal?
February 12, 2024 02:11PM
thanks Carey, that is very helpful!
Re: Can flutter be paroxysmal?
February 12, 2024 06:10PM
When I was having Flutter it could go back and forth all over the place in the different rhythms. AF, AFIB, FIB/Flutter (mixed AFIB and Flutter simultaneously) and NSR. Although mostly I would get Flutter alternating with Fib/Flutter, until I would get back to NSR, and then stabilize in NSR. This would happen most often when I was having an AFIB episode, and taking Flecainide, to try to get back into NSR. In addition my Flutter rate would vary, as the Atrial conduction rate would jump around from 6:1 to 2:1 corresponding with HR's varing from 44-136.

Flecianide is known to cause Flutter, even if you were in NSR to begin with, although it can ultimately help get us back to NSR.

As for your Attachments, it looks like Flutter to me, especially the first one, but a regular EKG would be needed to clarify. The second looks mostly Flutter, and the 3rd mostly NSR. If you were moving around changing exertions levels, or body position, this can contribute to these interchanging Rhythms.
Re: Can flutter be paroxysmal?
February 14, 2024 12:24AM
Has anyone tried sotalol or tikosyn for atrial flutter? My Doctor wants me to stop Flecianide and put me on one of the other antiarrhymic meds to help with my tachycardia. I am 3 months post ablation. He said the flecainide is causing atrial flutter.
Re: Can flutter be paroxysmal?
February 14, 2024 12:57AM
Both. Tikosyn was more effective than sotalol, and for me had fewer side effects since beta blockers suck the life out of me. One thing I was told by others and I found to be true was that Tikosyn becomes more effective the longer you take it.

But Tikosyn definitely requires a 3-day hospital stay, and if your doc is very conservative or if you tend towards a wide QT, sotalol might too (didn't for me). Women have naturally wider QTs so they're more likely to need the 3-day stay for sotalol.
Re: Can flutter be paroxysmal?
February 14, 2024 08:14PM
The first time I was diagnosed with arrhythmia at 59 in 1999 it was flutter. I was at home, sitting at the kitchen table eating a bowl of cereal with my heart rate monitor on in preparation for a run after breakfast and felt a little funny, not the ha! ha! type. I looked at my HR monitor and it registered 192 bpm. Set out to run, couldn't make 1/4 mile; couldn't get enough air to breathe. Subsequently diagnosed with both afib and flutter. Seventeen years later when I could no longer stay in NSR for a month w/o cardioversion, Dr. Natale did my first of three ablations and a Watchman implant. Life's been great ever since.
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