Pacemaker and Ablation

abalation

by inch - 2017-04-15 20:04:14

I had an abilation for atrial flutter.  I have an ICD pacemaker defib.  Been shocked many times and it saved my life.  The pacemaker for bradycardia is not a bad idea.  Mine is set for a rate of 70 now, before 5 years ago it was set for 40 as a net to save me.  My cardio Electro physioligist (you need one of these specialist)  found that my "bad beats" were coming in during the gap and then i would go into v tach.  Depends on WHY you are going into the slow rhythm  anything below 60 is brady.  some atheliet (bad spelling) normally run in a slow or less than 60.   just all depends.   again get an md that specializes    cardio electrophysiologist  i looked up the spelling.

Ablation/PM

by Adrian II - 2017-04-15 20:34:56

Thanks.   I have a referal for the electrophysiologist and am waiting to see what he says about my case.   I run, so I figured that's why I had the slow heart rate.  It's been dropping over the years and it's not supposed to be that low; 54 resting and lower sometimes.   I ran today and felt fine but on the other hand I don't want to drop dead on the track.  

Have had both typical atrial flutter and atypical atrial flutter

by parmeterr - 2017-04-15 22:51:22

Some people call them, type 1 and type 2.  Had typical atrial flutter ablated and cardioverted atypical flutter.  Typical atrial flutter is easy to ablate.  They know the pathway that the pulse makes and can ablate easily.  Atypical is much more difficult to ablate.  Success rate is about 80%.  Do you have third degree AV heart block?  If not, then you would know if you are in atrial flutter.  Your pulse would be transferred from the atrials through the AV node to the ventriculars.  Your bottom part of your heart would be beating the same as the top.  I have third degree AV heart block so no pulse from the atrials gets to the ventriculars.  They are independent of each other.  Atrial flutter is about 300 beats a minutes and makes a sawtooth pattern on an EKG.  Interesting to watch.  I go into atrial flutter just less than 1% of the time.  I feel it because of the reduced cardiac output not because of the heart rate.  When I do go into atrial flutter, I usually have 300 or beats per minute in the atrials and 60 to 70 in the ventriculars.  I also have a ICD CRT-D type of pacemaker.  Low heart function and also rate responsive. 

Richard

Ablation for flutter

by Selwyn - 2017-04-15 23:14:01

I have had a flutter ablation. The procedure is less prone to complications than atrial fibrillation ablation, taking a quarter of the time. It has a high success rate, though after a few years there is a relapse rate ( I have recently had one episode of flutter, electrocardioverted after 3 years. I expect taking Flecainide for atrial fibrillation does not help- especially if the dose is increased!).

Like you, I always thought my slow heart rate was due to fitness ( I did swim a mile yesterday, and ballroom dance for 2 hours). You must have some heart block otherwise your heart rate would be 140-150 /minute as this is the norm in atrial flutter, and there is a risk of blood clot formation in the atria. You will need to be anticoagulated if the flutter has been over 48 hours in duration.  The provision of a pacemaker will enable you to exercise more fully. Just make sure they adjust the rate response ( that is the heart rate simulator for exercise) of your PM.

Once the flutter is sorted, there is less risk of a blood clot/stroke. The PM will count for you whether you get any flutter or fibrillation ( look at the AMS readout on the check up print out).  Undected flutter is dangerous ( for you because of the risk of clots), and the heart functions less well without the shove of the atria to fill the ventricles.

All in all I would say you have a lot to gain by having an ablation and PM. Your exercise ability will be increased, there is less risk of having a stroke if the problem resolves. 

Best of luck,

Selwyn

PM and flutter

by Adrian II - 2017-04-16 04:17:05

      I'm a physical therapist but it's been years since I studied cardiac electrophysiology.    After my stress test the cardiologist told me my atrial pulse rate was 300 per minute.    Not good.  I was a little lightheaded and tired after but it didn't seem like a problem.   I've worked with many stroke patients and I can tell you strokes are a problem.    

Thanks for your feedback,    Adrian

Flutter

by Adrian II - 2017-04-17 20:21:38

How do you know you're in atrial flutter?     The way I found out was my cardiologist told me.  

I was a little lightheaded after the stress tess.  Later I was tired but the test was pretty nasty.

I was running uphill in the end.  I haven't pushed myself that hard in 20 years.  

Thanks,  Adrian