EAT or Atrial Flutter

[Noxx]

Hi!

26 year old male here. I was recently admitted to the ER for a fast heart rate (about 150 bpm at arrival). At first, the doctors suspected atrial flutter, and I was scheduled for an EC-cardioversion. However, they also did perform an Esophagus-ECG, after which they doubted the diagnosis of atrial flutter, and instead suspected Ectopic Atrial Tachycardia. Was sent home with a Beta blocker. Now I'm under investigation, but since doctors are gone for the summer, this will take a very long time. In the meantime I'm trying to get some answers here.

1. The esophagus-report said "On Esophagus ECG P-waves are seen, thus not an atrial flutter or fibrillation.". Do you agree that Atrial flutter could be ruled out due to this?

2. What could be the cause of EAT in my case? Normal blood tests, echo showed a borderline dilated left atrium, but nothing else.

3. Could the EAT have lead to the borderline dilation of my left atrium?

Since Im only 26 I'm concerned about having atrial flutter, since, as I understand it, this diagnosis is almost always for those with an underlying heart condition.

Thank you for your comments!

[Forum-M.D.-bkj]

Noxx,

It's been a while since I've seen an esophageal lead used to diagnose atrial rhythms.

Truthfully, without seing the ECG's it's impossible for me to specifically comment on the rhythm.  If they saw P waves you could have either flutter or some other type of atrial tachycardia.  Most often these are due to intrinsic pathways that are often managed with medication or ablation. An EP study could better help define the underlying cause and treatment options.  

I would seek consultation with an electrophysiologist.

good luck

[frs87]

Doctor, I do not know if I am asking this in the appropriate place but I have exactly the same doubt and I would like any help if it is possible. A have some photos.

Before I had the ablation, doctors said I had a PSVT. During the EP study, what they saw was actually an Atrial Flutter – which surprised them.

After it, I consulted another EP who saw my old result and said: “They said it was a PSVT? Well, I would diagnosis it as an Atrial Flutter”. I think he said something about being a “1:1 Atrial Flutter”.

These are some photos I took from my stress result that recorded my arrhythmia:

Page 1:
http://i2.photobucket.com/albums/y40/fristow/DSC05444.jpg

Page 2:
http://i2.photobucket.com/albums/y40/fristow/DSC05445.jpg

Page 3:
http://i2.photobucket.com/albums/y40/fristow/DSC05446.jpg (240 bpm!)

Page 4:
http://i2.photobucket.com/albums/y40/fristow/DSC05447.jpg

Please note I have cut off the pages showing sinus tachycardia. I am just posting the part (four pages) where I got the arrhythmia.

I am doing this question because now I am having the symptoms again, as I said a few times in other threads. What is your opinion? Is it a SVT or an Atrial Flutter?

I do not know if the photos are good enough, though.

Thanks.

[FLBrat]

All I know is that I would remove the photos with my full name and info from the internet.

[Slowboat42]

I  solved my issue with Ventricular Tachycardia (only a few inches from Atrial Tachycardia) to the astonishment of my doctors.  Fortunately, there is little or no risk as long as you follow your doctor’s medical plan.    

I kept track of my daily activity and food consumption for 15 months trying to get to the bottom line.  During this period, I recorded 700 events of VT as recorded on my ICD.  After careful analysis, I concluded  my VT’s were the result of low blood sugar either caused by significant physical activity, consuming sugar or other refined foods such as white flour, or by not consuming enough complex carbohydrates such as whole grain, legumes, fruits and vegetables.  I came to this conclusion in the ER after 6 hours of almost non stop VT.  The Atkins Diet is certainly a death wish for anyone suffering from VT’s or other life threatening arrhythmias.  Ironically, I was on a low carb, near Atkins diet because the drugs given to me to control my VT caused significant weight gain (Coreg).

Follow a nutrition plan recommended by the AHA or other health focused organization.  A diet of 50 to 60% complex carbohydrates should bring glycogen levels to a healthy level.  Avoid all refined foods and trans fat.

After 24 hours on an improved food plan, my VT’s disappeared completely.  I tried to find research supporting my conclusion on the internet but none could be found.  The only data available after countless searches is that the heart prefers glycogen (your body converts carbs to glycogen for storage) as fuel and that you’re liver and muscles (your heart is a muscle) are the only storage places and that storage is very small when compared to protein and fat.

I apologize for rambling but the topic is very complex and this solution is not the preferred alternative of the medical establishment.  Fortunately, it is a very safe alternative as long as you stay on your meds.  

BTW, my chronic premature ventricular contractions are almost non existent since the dietary change.

You may also want to take a muti-mineral supplement with at least 500mg magnesium.  Magnesium deficiency causes arrhythmia.

[frs87]

Oh, it is temporary, buy I do not see any problem at all. :)
I am not putting any compromising information, just a few strips from my stress test. Thanks for the advice anyway. :)
Ps.: It is in portuguese, I hope that doesn't compromise the understanding.

[RNRita]

Hi.  I am not a cardiologist nor a doctor but I am a cardiac nurse.  When I saw this rhythm at the hospital, we called is SVT.  The beats seem regular and I see it says 240 beats per minute.  This does not look like atrial flutter to me at all.  I believe it is SVT.  What did your doctor say?  

Supraventricular tachycardia is a rhythm that is from 150 to 250 beats per minute coming from above the ventricles.  I know atrial flutter can have an atrial rate of over 250, but the ventricular rate is not usually more than 150.  There is usually a sawtooth pattern between the QRS waves which I don't see her, but then again, these aren't the easiest to see.  

I would always check with my cardiologist, of course.

[sbenedetto]

A related discussion, very nauseated on the medicine was started.