Hi Everyone,
well, went to cardio follow up appt on Friday & thankfully saw a different cardiologist!
I told hm that the ectopics had improved a lot since October & that although I still had them sometimes they were nowhere near the rate & frequency that I was having when I wore the holter moniter. I said that I thought that this was because my anxiety is much better.
Also told him that I had stopped taking the betablockers after 2 weeks as hadn't got on with them, & he was fine about that!

Told him that I do still get flutters & rapid beats etc but that these don't last more than 10 seconds, I said that the other cardio thought that I was having atrial fibrillation. He said that he didn't think it was atrial fibrillation but he thought it was more likely that I was having bouts of atrial flutter & explained the extra circuit in the right atrium that causes this.

Although he said that the problem here can be the risk of a blood clot forming he said that because they only last a short time & my heart is structurally normal that this atrial flutter is more of a nuisance than anything & that most people take medication for it just for symptom relief.
I asked if I should be taking aspirin daily for it as I wasn't keen to & he said it was probably OK not to but obviously if they lasted longer or became more frequent then I would have to review it. He said that if it became a problem they could always burn the extra pathway away (ablation?) & that this was quite a simple procedure-is it ?!

He said that this wasn't caused by anxiety & that I had probably always had this extra pathway.
He didn't seem very concerned by my symptoms & said that they'd see me again in 5 years when I'm 50!

So, overall I was relieved & felt better about having a diagnosis of atrial flutter rather than atrial fibrillation but now I'm worrying a little about it as it seems to be something that I'll always have & I guess has the potential to get worse, not like anxiety-induced palps that can go away & I think I'll have to think seriously about taking the aspirin just as a precaution, just worry about the effects of aspirin on your stomach etc.

RLR-I'd really appreciate your views & opinions on this diagnosis & anything else you can tell me about it as I did google it when I got home but that was a bad idea (I know, I know) as some of the info was a little more worrying!!

Hope everyone is doing OK! Not many posts this week so that must be a good sign!!
Thanks for your support before my appt!
love Seffie xx

Well, it's as I said before; If you're persistent enough, someone will offer a physiological cause for your symptoms. Based upon your inquiry to me, however, I see it's done little in the way of bringing any sense of relief or comfort now that you have a physical diagnosis.

Although I'm certainly not here on the forum to challenge medical decisions by your own doctor, my personal opinion here is I don't agree with the evaluation that you have atrial flutter. Atrial flutter is associated with very rapid and often irregular contractions of the atria due to a re-entrant node (the extra pathway) that becomes excited and causes a rather cyclic electrical signal to perpetuate through the atria. It typically causes breathlessness, dizziness and nausea in most patients, with some patients describing the sensation as feeling as though a little motor is running inside their chest. Because the atria aren't able to properly contract during AF, blood can pool and given the right hemotological circumstances, a clot can form. In the absence of other pathology, such as history of heart disease or stroke, it is typically harmless.

Ablation is used to destroy the re-entrant pathway to stop the cyle that precedes and ultimately causes AF to take place. While it is not considered very invasive, ablation where re-entrant irregularities are not present does nothing to relieve the symptoms due to other causes.  

Correct me if I'm wrong, but I just don't recall you describing your symptoms as any sudden onset of tachycardia with associated irregular rhythm and I'm not speaking here about either of those events separately, but as a firm sequential and characteristic event.

AF is the consequence of a physiological abnormality and it's there to stay and produce symptoms until a decision is made where ablation techniques are warranted. You don't just experience a few palpitations here or there in the absence of other qualifying and necessary criteria. I certainly do not have the advantage of evaluating you directly or seeing the ECG for myself and I'm not in the position here to challenge the diagnosis. I'm merely stating that based upon the history of the complaint as you described it to me, I just don't see this being AF at all.  

Patients with health anxiety and somatic symptoms are often caught in a world of pure torment. They are compelled by uncertainty and fear to associate their symptoms with an underlying physical cause and when one if finally given, they subsequently employ the very same uncertainty and fear that originally brought them to the doctor's doorstep appealing for them to find a cause.

The only constant in this scenario is the uncertainty and fear based upon unwavering perspectives that are flawed in nature. You do realize that you can't live in purgatory. You must decide whether you're well or sick, but not both. If the palpitations are the consequence of stress-induced anxiety disorder, then you must proceed to treat it from that standpoint and move forward with your life knowing that you don't have any underlying disease.

By contrast, if you remain convinced that there is an underlying physical cause for your palpitation events, then you've already received the official diagnosis of AF and you must prepare to live out the remainder of your life within the restrictions of care and prevention associated with such a disorder.

As much as there is a pathway to choose from a healthcare standpoint, there is likewise a decision to be made regarding the identity of what compels you to continually place yourself in the position of uncertainty and subsequent fear. You can choose to ignore this characteristic, but it always manifest itself in one aspect or another until you do.

Best regards and Good Health

Hi Seffie
Bead here. You are lucky that you were able to see a more helfpul cardiologist and lucky that he offered to see you again (in five years - so that can't be bad).

I want to tell you that your symptoms sound exactly like mine from all your descriptions and I have been sent away. Despite being told that I have a faulty pathway in my heart (AV node re-entrant tachycardia). I was told that this may require ablation (to me a terrifying thought), but it has not happened in a while to my knowledge. Lot of other weird bumps and thumps and episodes that last up to half an hour of irregular fast heartbeat. I have been consoling myself with the idea that it is ectopics that sets all this stuff off. Has the faulty pathway been there all my life (I have no way of knowing - I doubt it as I have never had any heart palpitations all my life until these last two and a half years since which my heart reacts weirdly every day as you know!) Perhaps it is the ectopics that sets off the other irregularities and if we could get the ectopics under control everything else would abate too.
I certainly haven't had many of these AVNRT episodes (and they do feel very different to ectopics - just like rlr said a motor in your chest. Sort of buzzy like a fast machine gun. They do frighten me a lot because I know they are seriously considered. So while an abnormal pathway may not be caused by anxiety - having anxiety may be more likely to trigger it off - let's face it when your heart is going out of synch with ectopics I think that probably makes this a very likely scenario.
Try not to worry about what might happen - concentrate on here and now (I am trying too - I know it is hard!). Apparently statistics show that 95% of what we worry about never happens. Take care and we're here for your support.
bead xxx

This is the point I was alluding to earlier. The physiological presence of a re-entrant circuit in the heart tissue is not affected in the least by any reduction in anxiety or changes in stressors. It is a physical defect and responds to circumstances within the tissues and is not related to stress or anxiety but rather cellular and electrical conductivity variations within the heart.

My earlier post was intended to reflect the point that people need an answer for their symptoms. It is a common and unrelenting perspective is that if it's a physical symptom, then there is a corresponding physical cause.  

I'm truly glad that you feel better subsequent to your doctor's visit and it represents a suitable stopping point for me where the matter is concerned. Regardless of the underlying cause, I'll wish you the very best in hoping your symptoms are abated permanently and things return to an acceptable degree of normalcy for you.  

Best regards and Good Health