Sickness leading to A Flutter SVT and cardioversion.

Back in September I became sick with something cold and flu like but never tested for Covid. It took a few weeks before I felt better and it seemed that I never really did recover for even longer but I pushed on. Somewhere in the middle of October I noticed my heart rate was much faster than normal and by the end of October any strenuous activity, carrying something heavy going up stairs, snow blowing and even standing holding a guitar and singing in my band, would result in SVT. During a band gig in early November I ended up going to the ER where the SVT calmed into just A flutter 130 to 140 bpm and Afib when it slowed even more.

I have had Afib since 2018, and probably earlier just not diagnosed, and before this new Flutter problem after being sick this fall I had a nice NSR run of a year and a half. Following that ER trip I met with my doctor and he set me up with a holter monitor and an appointment with our local hospitals cardiologist department for a consult. The monitor reported 100% A flutter and the cardiologist of course suggested cardioversion and ablation. No changes to Cardizem metoprolol and propafenone, which were all at the minimal dose. I somehow fell through their cracks, which I take part blame for not being pro active, and was not contacted by their office until the beginning of January to schedule another consult this time with the EP who would do the ablation.

The consult was scheduled two months later at the end of February. A very long wait while still dealing with constant flutter and Afib.The day came for the consult and Ironically while walking up the long flight of stairs at the hospital to the cardiology office I went into an SVT episode 225 BPM. My consult became much different than expected but if you have to have an episode that was a good place to do it. He tried a few things to convert but it was unsuccessful. I was then sent to the ER where I did get the cardioversion I had been waiting since December for them to schedule. They then sent me by ambulance to another hospital two hours away so I could be observed by a cardiologist. We were told that our cardiologist approved of it which wasn’t true. At least this one suggested to change the propafenone dose.

So now, with that change along with the cardioversion,
I have been much more comfortable than I have been since October. I almost forgot what that felt like. It’s been an uncomfortable and challenging 4 months and it sometimes just feels good to share the experience with a population that understands. It is small but it feels like some progress and I do realize this is temporary and will continue to pursue other measures. What I would like to know is are the episodes of SVT most likely happening because of being compromised by continuous A flutter and Afib or am I now dealing with something independent of the other? I know they all seem to work together. Thanks for your time.



Edited 1 time(s). Last edit at 03/04/2024 10:42AM by JDfiB.

I think that illness was likely COVID and it left you with long COVID. The problems you've been experiencing are known to be associated with long COVID.

Thanks for confirming my hunch Carey.

Same with my story. I was stable in Sotalol unhh the uk I came down with vivid and then the flutter started.

Hopefully the new meds will work.

Not necessarily Covid. In 2022 just before Christmas, I started getting sick. It was the first year I had not gotten a flu vaccine in many years, and as luck would have it I tested positive for Flu Type "A". I was as sick as I have ever been in my life and I am 68 years old. I threw up and I pooped for days. I could not eat and was not hungry....just sick. The first week of January, I was a little better and was outside watching a new whole house generator being set. I was standing back out of the way on the driveway so I would not pass along what I had. For the first time in my life, I got dizzy and just fell over. I jumped back up and just blew it off. A few minutes later it happened again. This time one of the guys walked over to see if I was ok. I told him I was fine just a bit dizzy, but since they were about to leave, I was going to go lean against the car while they packed up. A couple of minutes later I woke up laying on the driveway after totally passing out. They wanted to call an ambulance, but I felt like I was fine and realized that I was most likely dehydrated, so I sent them on their way and went inside and drank a couple of big glasses of water. I had no more issues but called the doctor, and went in for a checkup, EKG, and blood work. Nothing showed any sign of stroke or heart attack so he also decided I must have been dehydrated.

Three weeks later I was pretty well over the flu, but woke up one night with my heart beating so hard I could not sleep on my left side. Happened again the next day so I went back to the doctor and a cardiologist. Could not get it slowed down so I ended up in the hospital and was diagnosed with A-Flutter. Meds worked most of the time but I did have one Cardioversion and attacks got more frequent and finally went for ablation. My Cardiologist said he thought I also had underlying A-Fib which I did and had a 2nd ablation for that. Have also now have a Loop Monitor and most recently a "Watchman" inserted. So far I have had no further issues.

I have asked a couple of cardiologists about Flu Type "A" being the catalyst for this. All said it was hard to say but did agree that it appeared that it was messing with me for sure due to the dizziness and passing out.

I also had a business partner who's 27-year-old son had Strep Throat one winter and by mid-summer was in a hospital on a heart pump waiting for a heart transplant when he died. The doctor was pretty sure that was due to the Strep Infection getting into his heart muscle and destroying it.



Edited 2 time(s). Last edit at 03/06/2024 04:16PM by JamesD.

Quote
susan.d
Same with my story. I was stable in Sotalol unhh the uk I came down with vivid and then the flutter started.
Hopefully the new meds will work.

I hope they work for you. After they found I had a flutter this fall they added metoprolol. I was already taking cardizem as a rate control for my afib. I can't say that the new med was effective but maybe they were doing something that I could not notice. It was not stopping the a flutter. Once I had the cardioversion I do notice that my resting heart rate has been in the low 60's and some times even as low as 57 bpm. It was never that low prior to having a flutter so I can only assume that it is the addition med.

I am re asking the last question from my original post. What I would like to know is are my episodes of SVT most likely happening because of being compromised by continuous A flutter and Afib or am I now dealing with something independent of the other? Is it common to have all three? My rate with SVT seems much higher than with A flutter which is terrifying when it happens..

Flutter is actually a type of SVT (there are several), so you might be imagining you have three arrhythmias when you really only have two: flutter and afib.

Flutter can occur in different pathways in the heart producing very different heart rates. I had two distinct flutter circuits when I went into Natale's lab in 2017. One of them originated in the LAA and produced a rate of 250 bpm. The other originated in the coronary sinus and produced a rate of 125. I had experienced both rates in the months preceding his ablation. I went into the procedure with the fast 250 bpm flutter in progress. He found the fast one in the LAA first and ablated it. I then dropped into flutter at a rate of 125. He found that in an entirely different location and ablated it, and I dropped into NSR.

So the answer to your question is it can be complicated. But there's no reason to be terrified. It will not kill you.

Thanks for the explanation Carey. It seems as if the fast version, 200+ BPM, presents itself when I do some strenuous physical activity i.e. lifting something very heavy and most recently walking up multiple flights of stairs. Also, it only occurred while I was in the slower 120 BPM version. Since my cardioversion and return to NSR I haven’t done anything of that type of stressful nature to know if it would happen on its own and not while I was already dealing with the 120 rate. I appreciate your helpful information.