he's baaack!

Well that slightly hubristic blog from last month is out the window. Here's what has happened.

My general condition has been good. I had a brief flutter episode Aug 15 during my workout. A brief pause and it resolved and I completed my program. Then nothing until two days ago on Sept 6. That episode was in the evening after dinner. It, too, resolved quickly. But change occurred yesterday morning. I felt an adrenaline surge with my coffee (decaf) post breakfast. I waited for the high HR to come down. It did briefly, then surged again. It did this for about 6 cycles all with highs in the 147 bpm range. This went on for 2 hours. Then it resolved finally However, I had another episode after lunch which resolved on its own. I was worried because my relaxation procedures were only momentarily effective this whole time. 

This continuing resurgence seemed the occasion to contact my rhythm doc. He wanted an EKG of an episode and/or a 30-day monitor. In the past each time I have gone to the ER the episode has been over and the EKG looks pretty normal. 

This morning's onset was a textbook copy of yesterday's. Immediately after finishing breakfast and relaxing with the Washington Post up went the HR after an adrenaline bump. I waited to see whether it would resolve with some relaxation. It did. But it returned again in a few minutes. We headed for the ER, about 1/4 mile away.

They hooked me up quickly to an EKG, 12-lead machine. It was all normal except for a PVC. However, on the 3-lead machine to which one remains hooked a few minutes later they caught an episode. HR bumped up into the 140s. ER doc said it looked like flutter, not fib. An enzyme symbolic of heart failure, BNP: B-Type Natriuretic Peptide, was slightly elevated. ER doc suggested a much greater increase would be necessary to talk about further heart failure. But he did note that today's amount was elevated over my prior baseline.

The ER doc then consulted with my rhythm doc's on-call partner:

I am to increase my use of the beta blocker, metoprolol, from 25 mg per day to 25 mg twice a day. This ought to be fun. I had serious lightheadedness when first taking this med a few months ago but after several weeks, not so much. And, if that proves too much, I can cut the pills in half.

Stay tuned.