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Q. Should I have ablation for atrial flutter?

Answered by
Dr. Muhammad M. Hanif Md.
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 06, 2016 and last reviewed on: Apr 17, 2020

Hi doctor,

I have been diagnosed with atrial flutter. I have been in this condition three times in the last two years. This is flutter and not fibrillation. Two years ago, I was stuck in atrial flutter, for three weeks. After being on an anticoagulant for three weeks, I went through a successful electrical cardioversion, and was free for two years. I am 73 years old, thin built and vegetarian for several years. I walk 4 miles a day. No other heart or health issues, other than some PVC, which I have had since youth. Six weeks ago, I had a flutter return for about 5 minutes. I went through a 24 hour monitor and was completely clear. I can tell when I get into flutter. It is clear and uncomfortable, but tolerable. Then, about a month ago, it returned and this time for about 8 hours. During that time, I had an EKG to confirm and my doctor transferred me to a cardiologist who can perform an ablation, on the right atrium. This new doctor was not too interested, in details, I felt and I am scheduled for this procedure in a few days. I am very statistical. I understand the flutter may return at any minute and it may not return ever, or for years. What is the subjective probability of returning flutter, each year, for my condition? Would you have a recommendation? Should I have this procedure? I am currently taking 5 mg ACE inhibitor and my BP is good with this.

Dr. Muhammad M. Hanif Md.

Cardiology Critical Care Physician General Medicine Internal Medicine
#

Hi,

Welcome to icliniq.com.

Thanks for the detailed query and I have reviewed every aspect of it to come to a point of decision that may be better for you in the long run.

  • The probability of getting unsure and unplanned episodes of atrial flutter seems to be high enough to warrant a procedural ablation right away.
  • The issue is not to bear the pain or discomfort you have when it is happening to you. The issue is that the damages it can cause or even cardiac arrest.
  • Doctor being least concerned to details may be due to the obvious signs and symptoms that may for you 100% as the candidate for ablation and he may not be wanting to waste time on details and come straight to work.
  • I know it is disturbing and that is the reason I always pay heed to details for patient satisfaction.
  • So, my final suggestion will be go for ablation as per your doctor's advice.

For further information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist


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Thank you doctor,

A friend had this ablation, and as a result, his resting pulse is now 100. It was about 60 before. He is uncomfortable, but no more flutter. What is the chance for this?

Dr. Muhammad M. Hanif Md.

Cardiology Critical Care Physician General Medicine Internal Medicine
#

Hi,

Welcome back to icliniq.com.

  • Actually, every patient has a different scenario. You cannot fit everyone's situation (pre-operative and post-operative) to any patient with atrial flutter.
  • But, your doubts are genuine and I can understand the sensitivity of heart issues when it comes especially to the rhythm of beats.
  • There are always accompanied complications with every procedure, but getting a higher heart rate is not that common amongst them that we may relate to ablation.
  • We ablate extra point of trigger in heart tissue that may be generating extra pulsation and interfere with original heart beats. So, not allowing the heart to pump in a synchronous way, thus causing flutter and in some fibrillations too.
  • I am unable to comment on your friend's case as I know nothing about his clinical scenario.
  • In your case, I hope best results as there seem to be least interfering factors that may lead to any issues post procedural.
  • Also, cardioversion worked superbly in your case meaning if we ablate the point of trigger, then you may get a flutter free heart forever. Your surgeon may help you better about the risks and complications before going through the actual procedure.

For further information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist


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