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Avatar universal

Has anyone been diagnosed with atrial tachycardia?

I had a catheter ablation eight weeks ago for avnrt.  Starting one week to the day after the ablation I have had brief runs (anywhere from 2-17 beats) of tachycardia every few days.  These runs only last a few seconds and so far have terminated on their own.  I have also been having skipped beats and a sense of a fluttery feeling in my heart (which only lasts 1-2 seconds and often precedes the tachycardia.) I wore a 48 hour monitor and the ep said it showed pacs and two short runs of atrial tachycardia.  Unfortunately I never felt the "fluttery" feeling while on the monitor.

So the question is.....why do I have this atrial tachycardia now??  The ep said it could be a new arrhythmia, or it could be a precursor of atrial fibrillation, or it could be from the irritation to the heart from the ablation.  I should mention that the avnrt that was ablated appears to be cured, according to the ep and the monitor readings.  I also wonder if I've either had it all along but it was masked by the avnrt (and he didn't find it during the ep study) or if somehow the ablation caused it.  Just seems strange to me that I would suddenly develop a new tachycardia one week after my ablation.

  Has anyone out there developed atrial tachycardia after an ablation?  Has anyone been diagnosed with atrial tachycardia?  The ep said it is not a dangerous arrhythmia.  He prescribed atenolol 25 mg.  But I am so upset that I now have a new arrhythmia after finally getting rid of the avnrt that I've had for most of my life!  I know it seems like it's normal to develop skipped beats after an ablation, but what about atrial tachycardia????

I am soooo upset with this.  Thought I'd be cured and on my way by now.  Looking for any help or answers!!!  Thank you!

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Avatar universal
had heart ablation surgery two weeks ago for atrial flutter..felt normal until 3 days ago..heart began to skip beats... then started  havin tachycardia  for short periods of time..now they are lasting longer..I;m in one now that has lasted all night....pulse is 120 bpm.  I took my 50mg of metopropol..so far it has not changed it.. also I now have pain in my shoulders....Jim
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Avatar universal
Hi Wendy,
No I didn't have any shortness of breath, but it seems like I've read posts from others who have experienced that after an ablation.
What did your doctor say about the atrial tachycardia when you were in the hospital after the ablation?
There was no rhyme or reason as to when my racing heart would act up in those months after the ablation.  I could be doing absolutely anything....making dinner, falling asleep, talking to someone....and off it would go.  I was so upset, thinking either the ablation had failed or that I had developed a new problem of atrial tachycardia.  But like you, I kept thinking it was mighty strange that I would develop a brand new arrhythmia right after having the original one fixed.  Then of course I started worrying that it had been there all along, but was masked by the more severe AVNRT!  
If you read back through this thread, there is a post from Is_Something_Wrong that quotes a doctor saying that short runs of atrial tachycardia are normal after an ablation.  I clung to the hope as I was going through the rough times!  I also should warn you that mine seemed to peak around the fourth or fifth week, which really freaked me out because it seemed to be getting worse instead of better! But it slowly but surely started to improve, taking about 4 1/2 months to finally settle down.  And even at that point my ep still wanted me to start on beta blockers just to shut it down all together.
Again, if you are really concerned you could call your doctor.  But it sounds from your post that it is not getting any worse, and maybe doing a bit better than that first night.
Reading through the posts on this thread and the related discussions might help you feel a bit better about the whole thing.
And like you, I hated the idea of taking a beta blocker after having had the ablation.  I was just disgusted to be on a new medicine after having taken a calcium channel blocker for years for the svt.  Being off meds was supposed to be one of the benefits of having the ablation!  But I have to say, the atenolol has really helped the random tachy runs and PACS and I feel so much better being on it.  It just seems to calm my whole system down, which is a good thing!  I know I was doing much better even before starting the atenolol, but that just sealed the deal!
Again, good luck, and try not to stress too much over this.  I think that contributes to the tachy runs too, at least for me.  And if you get concerned, call your doctor.  
Take care,
Annie
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Avatar universal
Thanks so much Annie.  I didn't know if anyone was still responding on here.  My night in the hospital, my heart rate went up to 180 three times and lasted a few minutes...which the doc said was atrial tach.  Since I have been home, I have been tachy up to 140 one time for a few mins, and last night woke up out of sleep with heart racing and only lasted a minute.  Wonder why it happens out of a sleep?  That's what it did in the hospital too.  I am not even two weeks out, so I'm trying not to stress too much.  Did you have any shortness of breath?
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Avatar universal
Hi Wendy,
I read your post and the other one where you described your symptoms and what you had your ablation for.  I know how scared and upset you are.  I felt exactly the same way!  I'm sure you read this whole post top to bottom and saw that many people responded to me and had the same situation that I did after the ablation.  I am happy to report that I feel fine 99.9% of the time now!

My doctor also did not lead me to expect any problems after the ablation.  I was told that for a couple of weeks I might experience some rapid beats, but was led to believe that after that I should be fine.  When I wasn't, I immediately thought something must be terribly wrong with me!  Luckily so many kind people on this website chipped in to let me know that they had similar situations after their ablations.

My tachycardia was so worrisome a few weeks after my ablation that I called the ep's office and went in and got a 24 hour monitor to wear.  It was after wearing that monitor that the ep told me I had had some atrial tachycardia episodes.  I was beside myself, having just had the ablation for AVNRT and now I had a new problem!?!

He wanted to see me again in three months, so at that point I was a little over 4 months post ablation.  By that time my symptoms were settling down a bit.  Not gone, but definitely trending in the right direction.  He prescribed atenolol, which seemed to be what I needed to completely shut down the tachycardia.  I still take the atenolol now, but the tachycardia and PACS are almost non-existent.

He told me not to worry about brief "tachy bursts" as he called them, which at the time were lasting just a few seconds to 20 seconds max.  So if the doctor wasn't worried, neither was I!

I also posted questions regarding this problem in the expert forum, if you want to try to find them to see what the cardiologist said about the tachycardia post ablation.

I did not experience the fullnes in my neck that you described in your other post, nor did I have the inappropriate sinus rhythm that you said you had.  If you are really concerned, I would call the doctor and try to get some feedback from him/her.  Because as much as everyone on this forum tries to help, none of us are doctors so we can't really say what is for sure going on with one another!

Good luck, Wendy!  Keep us posted!

Annie
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Avatar universal
Is anyone still posting on this forum???
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Avatar universal
I have it now too post ablation.  
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1137980 tn?1281285446
What a great post you just did...now thats what i call paying it forward...as far as the antenolol goes that is a very personal decision that you have to make for yourself.  I do know it is one of the lightest of the beta blocker famililes...i know the feeling tho about wanting to be med free just out of principle for sure...i chose the extra low dose myself because i wanted the whole thing behind me so now when i wake up in the morning i just take a half of one after i brush my teeth so it pretty much too me to the 99.9 percentile.  I don't know Annie....but if you think back to where you were a year ago vs. now...wow what a difference a day makes huh?  I would go w. what makes you feel better in your mind at this point...i am so glad that you are pretty much symtom free...i know it was a huge decision for you and for all of us as far as that goes.....you may want to ask your doc if its okay for you to only take it as needed for the rough edges...sometimes they allow that w. a light dose....congrats Annie and remember keep paying it forward to others on the site because thats what got both of us thru this.....
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Avatar universal
Hey Everyone,

You were all so kind to me back in July when I was in panic mode over my atrial tachycardia after my svt ablation.  Just wanted to update you.....I had another appt. with my EP last week, and all of you called it right!  My symptoms, while not completely gone, are so much better than they were in July.  I am now 6 months out from the ablation and feel like I am symptom free about 99% of the time.  Looking at all of the data, the doctor is confident that what I am experiencing are PACs and brief runs of PACs and he assured me that they are nothing to worry about.  He said he is not a bit concerned about these brief "tachy bursts" that only last a matter of seconds. So if he's not concerned, I'm not concerned!!!  :)

So thank you all again for your support and encouragement.  I was a panicky mess back then and I so appreciate all of you!

He has prescribed atenolol to alleviate the symptoms, but I am hesitant to take it.  For one thing, I hate the idea of going back on heart meds.  It's been a good feeling to be off of them these past 6 months after taking them for the past 15 years for the svt.  I am also concerned about side effects.  He thinks I should take it, but is giving me the flexibility to make my own decision, since it will only be for the relief of symptoms.  So that is something I will have to think about and see how much the symptoms really bother me.  I am going to wait and see, cause I kind of feel like now that he has said the tachy bursts are nothing to worry about and that I should try to ignore them, I really might be able to!
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1019152 tn?1336074292
Hi,I also have atrial tach and have had two episodes of afib in the last year.Now you had an rf ablation.?I was wondering did it get rid of your atrial tach?I went in to have a ep study and was suppose to have an ablation,but my doctor thought it would be too risky because it looked to him like it was too close to the av node. So he recommended I have the cryoablation done.Still am waiting to hear from a new doctor about that.Do you know of anybody that has had a cryoablation done for atrial tach? On one of annie1724 post she had thought her ablation had caused her atrial tach.So that makes me alittle nervous about having this done. Can I really get rid of this then if it can cause it.I too am on atenolol 50mg daily and have had no major side effects.  Thanks !! donna
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Avatar universal
Thank you all again for your help!

I'm glad to hear that you have not had any side effects from the Atenolol, Cindy.  I have been afraid to start taking it, fearing that the side effects would be worse that the mild symptoms I have been having. Guess I should start......

Not sure I'll ever get the nerve to do a double shot latte at Starbucks!  I had my worst post ablation tachycardia run after a large DECAF from Panera.  What a lightweight....geez!!!!
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1137980 tn?1281285446
Annie i so agree w. Debbier on this one w. the antenolol....i have chosen up until today to stay on the antenolol as a preventative....my heart doc who is one of the best in the world i have been told says that eventually antenolol at low doses as ours will become a maintenance med for all humans...meaning that normal people w/out heart issues will be taking it...i agree...i have had zero side effects from mine and just cont. to take it as a safety net for myself...just be sure to take it at the dose the doc told you to and make sure that you take it at the exact same time each day.....i take mine right after i brush my teeth in the morning....as you can tell alot of us have been thru this and come back to help others...i know in the beginning when i found this site JerryNJ was the one who settled me down and then i decided it was time to pay it forward...just as alot of us have done and hopefully you will too...we are rooting for you Annie....and.......

Debbier....you just burst my bubble!!! A caffeine soda?  Aw come on now.......i at least went back out and surfed again out at the coast...take a walk on the wild side Debbier go to Starbucks and do a double shot latte......LOL....
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1124887 tn?1313754891
I'm not sure if I said this: I'm diagnosed with atrial tachycardia and PACs, that's one reason I know about atrial arrhythmias.

I hope you'll be OK! Good luck, and just post if you have questions. We are all here for you :)
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503607 tn?1275671579
Hi Annie,

There are alot of us going through the panic stage of did my ablation fail.  I had my ablation 6 months ago today for afib and svt.  Right after the ablation I was having little runs of svt (I think) and they only lasted a few seconds, my EP told me it was normal the heart is trying to go the closed path but then realizes its no longer there and finds the right way.   I had those kinds of runs for the first couple of months.  I was just like you in a total panic.  Thanks to Cindy I was put back onto a more positive path.   It is normal for the heart to freak out after an ablation.  I am on 25mgs of atenolol since my ablation due to palpitations that could not be be ablated.  6 weeks ago I had a bad run of SVT all day, I was a lunatic I was so defeated but then I realized it was something I did, I took a zyrtec and started reducing my atenolol to 12.5.  I have not had any issues since I went back to the 25 mgs of atenolol.  My EP told me whenever I was brave enough to try again to reduce the meds I could.  I am now on my 4 day of being on 12.5 mgs and I am doing great.  I need to still watch what I take I think I just have a sensitive heart.    I just want you to not give up yet and become a mess,  its too early to hang out the white flag.  Try the atenolol and let things calm down and maybe in a few months when your heart is healed you can ask your EP to let you decrease your atenolol and come off altogether.     Good Luck!  We are hear for support.  I know this forum was a sanity saver for me.

Cindy, no bungee jumping here.  If I want to get crazy  I have a caffeine soda. lol!
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Avatar universal
Thank you both so much for your help.  I really do need to calm down about all of this.  For some reason I just have a real phobia about developing a-fib, ever since that one episode.  The SVT I've lived with for years, and while I'm glad it was ablated, the episodes didn't really scare me that much.  The a-fib episode was awful, lasted 12 hours, and scared the daylights out of me!  That's why I was so hoping that the SVT ablation would also stop the a-fib.  Which it still might....no evidence to the contrary yet.  I have to keep telling myself that.  But these short atrial tachycardia runs, and the ep's comment that they are a precursor for a-fib have just knocked me for a loop.  On the other hand, he also said they could be from the heart still healing, but being the way I am, I of course focus on the scary news.  Cindy, you hit the nail on the head in your description of me!  Right down to not liking to fly cause I'm not in control!!  In fact, your post made me teary eyed.....it was so kind and uplifting.

I guess I should start taking the Atenolol.  I have put it off cause I'm afraid the side effects will be worse than my tachycardia symptoms.  That's the thing....this silly atrial tachycardia only lasts on average about 10 beats and happens about every 5 days, so it's not like it's really even that bad to be stressing me out so much.  It's just all of the "what ifs" that I put myself through.  So I am torn....take the medicine (which the doc prescribed so I probably should!) which may cause more symptoms than the problem I am taking it for.....or not take it and maybe have this minor tachycardia develop into a-fib (if that's even how it works..not sure!)


I am going to try harder to focus on the positive about this.  Hopefully as you said, is_something_wrong, short runs of tachycardia after an ablation are perfectly normal and will eventually subside.  And hopefully 6 months out I will be feeling 100%.


In the meantime, I have to try not to worry so much about what "might be."  Easier said than done, as you both know!!!!!!!!!!!!!!!!

But thank you again for caring!  What a kind group of people on this board!!!!!!!
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1124887 tn?1313754891
Hello,

I referred to a cardiologist on a Norwegian "ask the doctor" service. He got several questions about this, one of the answers was:

"We often see an increase in premature beats and often some short runs of atrial tachycardia after an ablation, which is not a sign your ablation failed or the pathway wasn't properly cut".

Good luck :) Keep us updated.
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1137980 tn?1281285446
Sorry i didn't post earlier i was out of town for a couple of days....Annie i went thru the exact same thing that you did....both physically and mentally and i know how awful it is.  I ended back in the E.R, with a pulse rate 10 days after the procedure in the very upper 200's and you know that isn't a walk in the park by any means.  I too was converted, i too was put on the antenolol at .25 and i too was just sitting around waiting to die because i was sure i would.  Shoulda listened and trusted my doc...i think people like us are the type that hate flying because we are not in control of our lives and want to make things better for ourselves and sometimes Annie we are forced to give up that control and trust our docs.  I am now 3 years past my ablation and that incident and have had just one other that happened while i was sleeping but know i did it to myself.  I really burned the candle at both ends, forgot to take the antenolol for a couple of days...yada yada yada....live and learn....it took me a full 4-6 months to be symtom free Annie...i was my own worst enemy waiting for the ax to fall and there was no ax.....you have to learn patience here...your heart no doubt is still re learning the correct way for the electrical pattern to flow...up , over , around to get back to where it is supposed to be.....its like teaching a dog to sit...its repetitive and lets toss in the poking, prodding, penetrating and zapping your heart went thru...is it no wonder its still a little touchy...trust me when that day comes and you no longer feel your heart it will shock you.......i am 3 years out and literally 99.9% symtom free...time is your friend and patience is your BFF until you get over this...if you are having a tough time Annie you can message me so i can be here for you....Debbier went thru the same exact thing too....and now last i heard she was going bungee jumping LOL......
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Avatar universal
Wow, so you are self-taught!  That's amazing!!

Yes, my a-fib episode was absolutely a horrible experience.  Yet when my dad developed it, he didn't even know he was in it.  Just went to the doctor because he had been feeling so tired for a while.

Just one more question.....to benefit from your knowledge just a little more!  So how do you know that atrial tachycardia is really common after an ablation? have you read in all of your research?  Is that how you know, or did you experience it.....just curious cause I'm really searching for an answer!!!!  It seems like the most logical explanation to me,and I was sorry my doctor didn't jump on it!  He didn't say it wasn't, but he also wasn't overly encouraging that's what it was.  But I think sometimes they like to give us "worse case" scenarios so as to not get our hopes up.

Thank you in advance for you help again!!!!!  I really appreciate it!!
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1124887 tn?1313754891
Thanks for your feedback :)
Yes, I know a little about arrhythmias, it's knowledge I'd wish I could "unlearn", because my fear of arrhytmias have made me read tons of articles and cardiology journals. It's not recommended, by the way.

A-fib is not very pleasant in young people. We tend to get a rather quick ventricular response (because our hearts is strong enough to handle high heart rates). My dad got A-fib after heart surgery and he hardly noticed it (his avg heart rate was 55 during A-fib).

A-fib fires from several locations in the atrias (at least 3-6 locations, it's actually 3-6 simultanous SVT's) so I'm really not sure what your cardiologist meant when telling you it's the same location. AVNRT is not an atrial arrhythmia (it's supraventricular, but not atrial, it origin between atrias and ventricles) so I don't think Afib can origin there (I possibly misunderstood).

A PAC can (in theory) trigger A-fib. It can possibly happen if a PAC is very early in the heart beat cycle, like before the upper chambers have "repolarized" completely. It's a very rare condition, though. Many of us have thousands of PACs a day, and we never get A-fib. A-fib is usually caused by high blood pressure or other heart diseases. It's impossible to say what triggered your A-fib. I know it can occur in the "pause" after a supraventricular tachycardia for some reason, in some people.

I think the atrial tachycardia will stop after some time. It's really common after an ablation, and it's no indication that your ablation failed. AVNRT is a very specific arrhythmia, with a very specific cause (double pathway through the AV node). I think you should consider the A-fib event as an one-time event. If it happens again, another ablation can take care of it.

Keep in touch with your doctor, and try not to "read yourself sick".

Take care,
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Avatar universal
Hi again,

Thank you for answering!  As you can tell, I am very worried about all of this!

But in answer to your question about my a-fib episode.....Yes it was definitely a-fib.  On a heart monitor in the hospital....it went on for 12 hours....treated with IV cardizem and digoxin.  So that's why this is a real concern for me.  Though it occurred after an episode of svt.  The svt converted on its own to a-fib while I was at home.  I went to the hospital because the symptoms of a-fib were worse than anything I had ever experienced in all my years having svt.  So the cardiologist was hopeful that since I don't have any other pre-determining factors for a-fib that the svt might have been the trigger.  That's why I'm so down about the atrial tachycardia, also caught on a monitor.  He says it fires from around the same area as a-fib.  So I'm so worried about that.  But on the other hand, in addition to the atrial tachycardia I am also having PACs, also verified on a heart monitor, and I know they can trigger a-fib too, if it's meant to be, so I don't really know if the atrial tachycardia is any more of a risk than the PACs.

The doctor did also say that he wanted me on a very low dose of a beta blocker, which is why he prescribed 25 mg of atenolol as opposed to anything else.  ANd he also told me to drop back from one adult size aspirin a day to one baby aspirin, so it's not like he sees me in immediate danger.  But I guess I just wanted this to all go away after the ablation so badly that I am now so disappointed and that is feeding my anxiety about the whole situation.


I appreciate your answers so much!  You seem so knowledgable!!  Thank you!!!!!
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1124887 tn?1313754891
Annie:

First thing first: The fact that your cardiologist put you on 25 mg Atenolol does NOT imply your condition is serious. Serious arrhythmias are treated with certain anti-arrhythmic drugs or beta blockers in 5-10 times as high dosage as you were given. 25 mg Atenolol will remove some adrenaline effect on your heart, that's it, and hopefully give some relief from your innocent, but annoying symptoms.

Atrial tachycardia is not necessarily a precursor for A-fib. It all depends on the mechanisms. If you've just got an annoyed spot in your heart firing off some PACs now and then (like you probably got, especially if Atenolol in such a small dosage helps), A-fib triggered by this arrhythmia is really unlikely.

The episode of A-fib before ablation, is it verified by EKG, or is it just an assumption due to irregular heart rate?

If you really have a tendency to A-fib, I believe the EP would have managed to trigger the arrhythmia during the EP study?

Anyway: A-fib is not life threatening and it's fixable by an ablation. I recommend you to not worry before this actually is a problem (if it ever will be).
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Avatar universal
Thanks for your help!  I'm driving myself crazy worrying about this.  But the thing is, my doctor did seem concerned enough to put me on atenolol, and he's the one who mentioned that atrial tachycardia is a precursor for atrial fibrillation, so that's why I'm so worried.  I had been thinking these symptoms were still from my heart healing from the ablation, and that's what  I expected him to tell me when I had my appt on Friday.  Then he brought up all that other scary stuff!

He did mention that there was an outside chance the atrial tachycardia was from my heart still being irritated from the ablation, so I guess that's what I have to keep hoping for.  Cause really, if I had the atrial tachycardia all along, shouldn't it have shown up in the ep study before the ablation??  I didn't think to ask him that.  But I would think they would study the whole heart before ablating.  And it's just too weird to think that I suddenly developed a new arrhythmia one week after my ablation.  BLAH!!!!  Why won't this just go away?????
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1124887 tn?1313754891
Concerning atrial flutter:

Atrial flutter is an extremely quick atrial / supraventricular tachycardia. It's so quick, that some of the heartbeats (usually 1 of 2) is blocked / prevented from reaching the main chambers, and not creating heartbeats. Atrial flutter will probably cause an atrial heart rate of 300 and ventricular heart rate of 150 or 75 (1:2 or 1:4 block). Atrial flutter rarely causes "flutter" as you mention (atrial heart beats are to weak to cause any significant sensation, especially at the rate 300, where blood filling before each beat is minimal).

Atrial flutter is usually sustained (not lasting just a few seconds), but it can be hard to notice, because at 1:4 block (most common at rest) it can almost mimic normal sinus rhythm. Slight exercise can change the flutter into 1:2 block, heart rate 150, which is more noticeable. Some people get a 1:1 atrial/ventricular response, causing a heart rate of 300 during exercise, that causes fainting.

If I were you, I'd try to accept that short runs of atrial tachycardia and PAC couplets/triplets are a benign phenomenon, and common after an ablation. Do not search the internet for possible dx, it will eventually drive you crazy, and you will stumble upon dangerous arrhythmias that "match" your symptoms. I know, because I've done it myself (how do I know this much about arrhythmias?)

Trust your doctor, reduce your stress levels (that are the main trigger for arrhythmias) and see your doctor if something get worse (like fainting, dizziness with high heart rate, chest pain or similar).

Good luck!
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86819 tn?1378947492
One other thing. I did have my king of heart prescribed for 30 days and kept it an additional 5 or so more.  In the last several days, we caught an important event.
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86819 tn?1378947492
There is a heart monitor called the king of hearts that is widely used. This monitor continuously stores the last 30-45 seconds of heart rhythm information in its memory.  When you press the button, that last30-45 seconds that it already has in volatile memory is stored in non-volatile memory, along with another 30-45 seconds or more of additional data (I think it is programmable). The electronic data are stamped with the time and date.  You can record a few of these, and then you call the doctors office and upload you king of hearts stuff to the doctor over the phone.

If you were have symptoms like those you describe, and were wearing one of these, you could press the button, then record comments (such as "on July 10th at 1015pm, I recorded by flutters) in a diary. You would then have everything you need to know what symptoms are heart rhythm related and which are not.

I had an ablation in 2004 for WPW.  After my ablation I experienced a lot of symptoms, including a very distinctive fluttering sensation in my chest that lasted just a few seconds at a time. Using the king of hearts and a diary we determined that my flutters were not correlated with a heart rhythm issue. They eventually went away permanently.

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