Atrial Flutter...What Next?



  • Hi. I have reluctantly come to the conclusion that I may have this problem. Had  several instances of having to stop on races after a couple of breath, can't maintain speed etc. Saw the doctor and tried an asthma inhaler but follow on appointment concluded that this isn't the problem or solution. Going back to see dic in a couple of weeks.

    Problem goes away after a couple of days,vbut is getting more frequent. Now vfeel I can't raise pace on a nine race run.

    Anyone with advice, I would be delighted to read more







  • MrM2MrM2 ✭✭✭

    Greetings Rob.     It was only due to my routine of daily heart rate checks that I knew the cause of my sudden breathlessness.

    Do you check your pulse before/after/during runs?  It's not something that I sweat about, but it does give me another thread of information.

    Hope you get some help from the doc. soon.

    Howard Thomas 3  Hope everything has gone to plan. Let us know how you are.

  • Hi Guys. Now back home after a successful op which was cancelled on the original day because of hospital emergencies but took place yesterday. It took about 2 hrs and I was out of it most of the time except for a slightly painful bit during which I was given more sedative. Today after 13 hrs sleep I feel ok and looking forward to a few days resting up. My atrial flutter was a very straightforward one and the consultant said that they knew exactly where to locate it. After suffering a pulse of 28-34 bpm for 6 months with all the related problems of breathlessness when running, dizziness and nausea, and also lightly swollen ankles, I am already noticing the difference and my resting pulse is up to 54 bpm. Of course, I can't report back on the running until after the rehab.

    I note that Rob reports breathlessness. Here I would endorse the advice of MrM2 and make a habit of taking your pulse regularly - getting out of bed in the morning and at any other period of rest. I had severe breathlessness and it was only when I noticed that my pulse had dropped from 44-46 bpm to 28-32 bpm that I realised that that I had a heart problem and saw the doc fairly soon after. That was last October and it has taken until now to get into the operating theatre. 

    So Guys, very many thanks for your help and support thus far, I'll report back on progress soon.

    best wishes



  • MrM2MrM2 ✭✭✭

    Howard.    Great to have your first report sounding so positive. I hope and pray that this will continue. Would be good to hear how you progress.

    The ship that I am on has been in Durban, South Africa, for just over a week. We've had a real mix of weather, but I've been able to get out for a run on alternate days. They have a great sea-front promenade that is used by walkers, runners and cyclists. It is also used by monkeys, which I don't encounter in Bournemouth!

    There is a 'Parkrun' along the prom. which I hope to run on Saturday. It's hard to visualise, but last week they had over 1300 finishers!

    This morning's run was a 5' slow/fast alternate miles, and was quite pleased to manage the two fast miles at 8:24 and 8:16.  Happy days.

  • Thanks for the heart rate measurement tip...I will try

  • Hi Everyone. Thought I'd give you an update 8 days after the op. I felt ok after 24 hrs and have no post op pain. My pulse varies from mid 40s - mid 50s and still skips beats, but this is apparently to be expected. But it now seems to react properly to the demands of exercise, that is, it rises quickly according to need. This data has come from my heart monitor which I have worn on a daily walk of c.1.5m at a gentle to steady pace. I feel as if I could run/jog but I am waiting at least until the 10 days advised by the cardilogist has passed, but I am prepared to wait longer if it's required to make sure the ablation healing has taken place.

    Which brings me to my question to MrM2 and Redjeep, did you follow doctor's guidelines re returning to running or did you go by how you felt? Redjeep, I know that you still might not have started up again. Is that because you haven't felt up to it or are you being cautious?

    Re the healing process following radio frequency ablation, I have tried to find info on the web about it but have not uncovered much. I also think there is a wide general discrepancy about how the word 'exercise' is understood. For some it's a gentle walk to the end of the garden and back, for runners it's something else of course. In my case the cardiologist was a runner and when he said 10 days before starting up again, I am assuming he meant running. But what have doctors told you guys, for example? (By the way, I do appreciate the caveat that we all may react differently and no one knows how severe the the procedure was in each of our cases.)

    Here's hoping that this message finds you all well.,

    Best wishes


  • MrM2MrM2 ✭✭✭

    Howard..Good to have your up-date.

    Answering your question...After my ablation I was told to wait a week before considering any physical activities. So I waited 8 days and started cautiously walking at various speeds; really just checking for groin discomforts. By the end of that week I had notched up 18 miles, including an 8' run. The next week I clocked up 21 miles and then 23 miles for the fourth week. In the second month I experimented with pace, and distances up to half-marathon.

    My caution at the start was simply following doctor's advice, but I never felt my body telling me to take it easy. I did a lot of heart-rate checking in the first two months, but since then I have rarely checked it during a run.

    Redjeep...Hope you'll soon be up-dating us on your progress.

    I'm still in Durban, South Africa. Decided to run the North Beach Parkrun last week. My time was 26:03, and I finished 137 out of 1251 finishers! Reasonably pleased with my time, although it is 1:40 slower than last summer, in Bournemouth. It still placed me first in age group (11 runners in the 70-74 category) with an age-grading around 68%.

    Not sure how things will work out for running over the next month, as we'll be in a more difficult area, in dry-dock. Happy recoveries everybody.

  • RedjeepRedjeep ✭✭✭

    Hi Howard. Good to see it all went well and you're starting on the road to recovery. I followed my doctor's advice and only started back training yesterday. Tomorrow will be 6 weeks to the day and I did 45 minutes on the turbo yesterday and 60 today. I was taking it fairly easy so no hard interval sessions for a while.

    I was thinking of going for a run this morning with my usual Sunday morning crowd, but chose to do the turbo instead as I felt that it'd be a bit more controllable and I was less likely to get too carried away. I'm planning to run on Tuesday evening, but it'll only be for a mile or 2.

    I've felt fit enough to start back for a couple of weeks now, but thought that I'd better do what I'm told. I've been doing some longish walks since a few days after the op (about 1 mile slowly to start).


  • Hi Guys

    Many thanks for your responses. Redjeep and Michael, it seems that your doctors have given different advice seeing that M started exercise again after 8+ days and R after 6 weeks. My cardio said no vigorous exercise for at least 10 days but going out for a walk was ok, hence my 30 min gentle to normal pace walks since op day + 2. Today, op day + 10, I walked for an hour around a forest plus another hour or so walking around an NT property. I suppose the issue is less the groin area but the healing of the cars in the heart, and I can't get any hard info on that, so I suppose we each listen to our own cardiologists.

    My pulse seems to very from 47 - 60 but is mainly in the 50-52 area. I also experience an occasional, kind of pressure head ache, which under normal circumstances I would cure with a run. Does any of that sound familiar? Whatever, I shall start gentle jogging in the next few days and get back to you.

    Good luck with the turbo trainer, Redjeep, it's a great form of exercise and well done M on your brilliant 5 k run in SA. I would be very pleased to run that sort of time again.

    Best wishes


  • Dr.DanDr.Dan ✭✭✭

     Interesting reading this thread ... I had some issues back in the day

    but have been clear since having an ablation in 2010.

  • RedjeepRedjeep ✭✭✭

    I ran tonight for the first time since Christmas. However I'm not sure that it could actually be described as running.

    I did 3 miles slow, the first 1 1/2 miles with the group I normally run with and I felt like I'd never ran in my life.

    Ah well. Another hill to climb.


  • MrM2MrM2 ✭✭✭

    Dr.Dan    Glad to hear that you have been clear since 2010. Long may it continue.

    Howard   All the best as you get back into running.

    Redjeep   Early days; you've been out for more than three months. Take it easy, and enjoy getting back to some regular running.

    I'm feeling a bit cooped-up at the moment. In a restricted port area and unable to 'just do it' but hoping to get out soon. Have been following the mixed fortunes of Paris runners on another thread. Amazed, as always, by the performances of the elite runners; Kenyan 1,2,3, all finishing within seconds of each other, around 2:07!!! London has a great line-up. Will probably just get the results.

    Let us know from time to time how you are getting on. All the best.

  • RedjeepRedjeep ✭✭✭

    After my 3 mile run last Tuesday I didn't stop aching until Saturday. I honestly felt worse than I did after a marathon.

    Out again tonight and I struggled to do 2 1/2 miles at 10 min pace. Bit depressed really as I don't know if it's just lack of fitness or a side effect of the op or the meds that I'm on.

    I'm not back to see the surgeon until the end of May, so will try to keep getting out and doing short runs until then. I had no idea that I was going to feel like this.

  • MrM2MrM2 ✭✭✭

    Ablation + 18 months.

    Redjeep, Howard, Rob....Haven't heard from you for a little while. How are things?

    Yesterday (1st May) was a great day for me. It was my 72nd birthday, and our final day in the port of Durban. It just happened to coincide with the Deloitte Challenge; a day of running events. There was a full marathon, a half, a 10k and a Fun Run, plus a 40k cycle ride. Over 5000 people were signed up, but on the day the total was nearer 4000 competitors.

    For the past few months I've been encouraging a much younger shipmate with his running; gradually extending his distance. We have done quite a bit of training together, and I've tried to get him into good habits; working at various paces, good preparations, and a range of stretches to finish with.

    Yesterday we ran the half marathon. He wanted us to run together, but with 10k to go, I told him to push on at his own pace. He finished 8 minutes ahead of me! But he has needed to learn how to hold a steady, sustainable pace.

    He was delighted with his time of 1:50, and I wasn't disappointed with 1:58. I'm sure he could work towards a time of 1:30 in the near future, if he applies himself.

    My Garmin gave a distance of 13.2', and showed a 10k of 53:15, a  5k of 25:56, and a best mile of 7:57 The Age-Graded tables give me 70% for the half marathon and for the 10k, but slightly under for the 5k.

    We are sailing up the coast for a few hours, to Richards Bay. I'll be leaving the ship there, and will spend a few days in S.Africa before heading back to England later this month.  Hope you guys will get back to enjoying your activities soon.

  • Hi Guys and happy birthday, Michael. Good news and maybe some not so good news from me. The recovery has been going well and I am back running and it feels very much better than before the op. I can run sub 10 min mile pace easily and I'm quite relaxed and not breathless. I also feel that I could run a lot faster if I need to.

    But the bad news is that I have noticed in the last week or so that my resting pulse on waking is low again 39/40 and it is very irregular with lots of missed beats. It picks up again when I move around and during the day it is about 49-54 bpm. Fortunately my chronotopic response seems to be back again (i.e. when the pulse rises in accordance with demand). However one of the sure signs of a problem is oedema around the ankles and this morning I noticed it once more , compared with after the op when it disappeared very quickly as my pulse was much higher and more regular. This new development could mean that the heart is not efficient and is not clearing away excess fluids around the body.

    To say that I am hacked off and disappointed is an understatement. I have not yet been signed off by the cardiologist and that is not due until 3 months after the op, which is in 6 weeks time. But shall be checking in with the doctor asap to see if I can advance the appointment. I did not go mad during the recovery and did not start light jogging until at least 15/16 days after the op, and even then it was only for a few minutes at a time. It's only been in the last week or so that I have run continuously for periods of 5 mins building up to half an hour.

    Meanwhile I have decided to carry on running on a light programme and going to the gym etc in the hope that it will settle down again. I also go orienteering at least once a week but that is a mixture of walking and jogging.

    A running friend mentioned to me today that sometimes an ablation is repeated, but I still have the cardiologist's words ringing in my ears that the AFL ablation is usually 95% successful, and if it didn't work for me, then I would be looking at having a pace maker fitted. Ah well, we'll see what happens.

    I'll keep you posted.


  • MrM2MrM2 ✭✭✭

    Howard.   Thanks for the up-date. Quite a mixed result at this stage. Hope that things will either settle or get sorted soon. Glad that you are able to resume some activities.

    Yes, I have heard of procedures being repeated, with improved results. Hope that you can get a review soon, and that your specialist will be able to come up with an answer.     All the best. 

  • Hi all, thought I would drop back in just to update really i had cryo ablation in August 2013 following various incidents and a blow up at Outlaw 2012.

    So, nearly three years. My MHR before ablation (BA) was about 212, now 185 if I am lucky, 10k PB was just under 50 mins, now about 58. RHR BA was 54, now about 65-68. Erratic beats still? Yes. But usually only for no more than 5-10 seconds maybe. Apparently has to be 30 seconds to count as AF. Lots of issues re acid reflux and this triggering odd erratic beats via vagal nerve we think. Thank God for Omeprazole!

    Sprint finish is now about 20 yards, had 80 before. Ticker seems about 80% of what it was before. Runs 8 miles are a problem. At least double hydration with electrolytes needed now for every run.

    55 years old now (shut up Meldy and Plum). Still going, done one tri since ablation, like to do another but sprint is probably limit. Feel quite fragile very easily with dizzy spells etc.

    Hope this helps someone.



  • MrM2MrM2 ✭✭✭

    Dustboy.  Good to hear from you. Your experience is quite different from mine, but will be of interest to other readers I'm sure.

    You seem to have a few issues, but still manage to keep involved, which is great.

    Do you find the swimming and cycling are affected as much as your running?

    All the best!

  • RedjeepRedjeep ✭✭✭

    Happy Birthday Michael, glad to hear it went well.

    Sorry Howard that it's not going well. Hopefully it will all get sorted soon.


    Good to see everybody back, it had all gone very quiet for a while. To expand on what Dustboy was saying, my RHR has gone up from around 45 to 60, but seems to respond well to exercise. I was monitoring it on the turbo this week and I seemed able to get it to stabilise at the correct level.

    I'm still struggling with running, but was able to run 5 1/2 miles on Thursday at a 9 min 20 sec pace, which is the furthest and fastest I've managed since it all started over Christmas.

    Cycling seems easier than running, but I don't know if that's down to fitness, the op or weight gain.

    I have a follow up with the surgeon in a couple of weeks so I'll see what he has to say.

  • MrM2MrM2 ✭✭✭


    Thanks for your greetings.

    Good to have your up-date. Some progress with the running, but not as much as you would like, but doing better with the cycling. Great that you can remain positive (?) with on-going difficulties. Sure I'd be climbing up the wall by now! Hope that your follow-up goes well in a couple of weeks.

    Don't let weight-gain set in, it will be hard to reverse. All the best. Michael.


  • RedjeepRedjeep ✭✭✭

    Thanks Michael, I'm hoping that this is about as bad as it gets and now that I'm back training it will all sort itself out again. My only concern is that I can't do the volumes that I was doing previously, but I hope that this will start to ramp.

    I suppose part of the issue is that until I see the surgeon again, I don't really know what I can set as a target and so no races on the calendar for the first time in 10 years +.

    The surgeon did say that I was to do no more marathons ever again image, but my regular consultant did make a comment to me before that about how it wasn't his job to prevent us doing things, but it was his job to enable us to do things that we aren't able to do. Hopefully this means that he will reverse the surgeon's (who he recommended and is a close friend) decision.

  • Hi everyone, I'm so glad I found this thread - it's so encouraging to see that many of you are doing well after your ablation.  I had my ablation (for right ventricular outflow tract tachycardia, which was brought on through exercise) 2 days ago and I'm already getting impatient and want to get out and run and see if it's worked (I've been told no hard exercise for a week at least ). The procedure itself was fine - nothing too painful, and I was up and able to walk 4 hours after the surgery (I had only local anaesthetic, so didnt need the long recovery time that is required following general anaesthetic). Now, 2 days later, it hurts a bit to walk because of the puncture site on the top of my leg, and I get the odd twinge in my heart ,which they told me to expect. But other than that i feel fine! The cardiologist said that 90% chance that it has worked and I really hope that it has. My aim is to reach (or even beat!) my previous PB for a half marathon (1.39 -  in 2012) which, considering I was running 11-12 minute miles just pre-surgery might be too big a goal. But this thread has definitely encouraged me that getting back to a decent pace is possible following ablation image 

  • MrM2MrM2 ✭✭✭

    Helzbelz1984....Thanks for calling in. Glad that you have found some encouragement here. I know just what you mean about getting impatient, to 'see if it's worked'. But do give it time, and you will be giving yourself the best chance of getting back to where you were.

    That was my journey, and I can honestly say (almost 19 months post-ablation) that my Atrial Flutter is just a memory; with no current issues to suggest that I am anything other than 100% restored.

    I only got back to UK two days ago, after 8 months away in some very warm parts of the world, and I'm keen to get back into some regular running.

    On May 1st I enjoyed a half marathon in Durban, and on the 14th I was able to run the Durban, North Beach, Parkrun in a time of 25:30, on very little specific training.  Hopefully I'll be able to get back to nearer 24, while at the same time working towards another marathon.

    Keep us up-dated with your progress, in the weeks ahead. 

  • Thanks so much for the advice MrM2! It's so good to hear you're fully healed and are enjoying running again. I'll definitely take it slow - just walking up the stairs in my house today has made me breathless, which makes me worry that it hasn't worked :-/ but I'll try and go for a short and slow run next weekend and will report back with my progress updates image

  • RedjeepRedjeep ✭✭✭

    Hi helzbelz (is that an AC/DC reference ? ? ), don't worry too much at the moment, but check your heart rate to see if it's stable. You're bound to feel weak as your heart is still recovering. There's a lot of internal scarring and swelling after the op.

    I was very impatient for the first few weeks and went walking 2 - 3 miles per day every day for the first week and then worried why I felt so bad a week after the op. I actually went back to see the surgeon who made the comment that everybody underestimates how serious the surgery is 'because we don't open your chest with a saw'.

    I did nothing from the second week until the 6'th week. I was told absolutely no running or cycling for 6 weeks,  so don't try and do anything too soon. I asked if I could at least go for a gentle jog before then and he looked at me like i was stupid and just repeated absolutely no running or cycling for 6 weeks.

    I'm feeling much better now, but can still only manage around 6 miles at one minute per mile slower than my marathon pace, but I think that's because I'm only doing 1 or max 2 runs per week, so need to ramp up, 

    I have a question for everybody else. I still have numbness along the back of my right thigh, downstream from the incision to pretty much the back of my knee. I also have a hard swelling in my groin (oh, err Matron), around the incision.

    Did anybody else have this ? I'm not sure if it's normal or not. The swelling creeps me out as it's so odd.

    I'm back to see the surgeon on Tuesday so will ask him, but thought I'd ask everybody here first. 

  • Hi Redjeep, thanks for your advice ! It's so easy to underestimate how serious the surgery is because generally I feel fine - it's only when I walk upstairs when I remember that I had heart surgery only 3 days ago ! It's also good to hear from other people who understand the frustration of having to do nothing - I don't know how you coped with no exercise for 6 weeks! They told me that a week off should be enough so I'm hoping that's the case. Good to hear you're better now - keep us updated with your progress image.

    Re. your swelling, they told me to expect a pea-sized hard lump around the incision site 1 week after surgery. So I guess this is normal, although yours is a lot later than 1 week so I'm not sure how common this is... .

    Helzbelz (no AC/DC reference I'm afraid image)

  • RedjeepRedjeep ✭✭✭

    I was back with the surgeon today for my check up. He thinks that the swelling is due to damage to the artery and that it'll need a follow up op to repair it.

    Hopefully that''ll be in about 6 weeks.

    Oh bugger.

    He also said to back off on the training.

    Double bugger.


  • Oh no so sorry to hear that Rejeep - that sucks image. Could you do alternative training that doesn't use your legs so much ? Like some easy rowing ? Just to keep you sane...

    I contacted the hospital yesterday cos my heart keeps going crazy (& it feels like VT) from walking upstairs (I'm now 6 days post ablation). They've booked me in for another 24hour ECG on 7th June so that'll show whether or not i'm still getting it. Did anyone else get these problems after ablation ? Or did you feel 'fixed' pretty much straight away? 

  • MrM2MrM2 ✭✭✭

    Sorry to hear of recovery problems. My return to running, post ablation, was very smooth, although I did take a full month of 'finding out'. I experienced a few strange readings on the heart rate monitor, but never had the feeling that the readings were true (?) and never had a satisfactory explanation. 

    Hope things start to get sorted out soon, and that you can enjoy your running again.

  • RedjeepRedjeep ✭✭✭

    Hi all,

    I haven't posted here since I was told I needed another operation as I've not been on best form. For the record, my lump was about the size of a golfball implanted a little way under the skin.

    Anyway I had the operation on Monday and now feel that I'm recovering well. The surgeon told me that there was a small hole on the back of the pulmonary artery and he was surprised how big the swelling was once he opened me up. The op took about 2 hours and when I came around I had to lie flat on my back for 24 hours. I couldn't sit up or roll over. I certainly couldn't get out of bed. After the first 4 hours they raised the head of the bed. In all, the op took longer than the ablation and the recovery so far has been harder.

    I got up the following morning and was allowed to do a few brief walks around the ward each day. I think I raised a few eyebrows as everybody else on the ward was much older and stumbled around in traditional pyjamas and zimmer frames, whilst I had on a bright yellow marathon top and shorts. image

    I was discharged on Wednesday afternoon and have spent the rest of the week lying on the sofa. 

    I'm planning to start back gently on the turbo trainer next week and probably won't run for another couple of weeks.

    However, overall I feel good and woke up on the Tuesday with a real feeling of 'well I'm over this now'. I spent a lot of time when I was flat on my back thinking about a big event to celebrate towards the end of the year and fancy a multi day cycle tour.


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