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!

[sbenedetto]

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

[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.

[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.

[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

[FLBrat]

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

[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

[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