When AFib & atrial flutter entered the story
Latest update: September 2026
I thought closing my PFO might allow me to put the cardiovascular side of my stroke behind me. Instead, another part of the story gradually emerged: not the structure of my heart this time, but its rhythm.
What followed was a long period of symptoms, monitoring, uncertainty and trying to understand why exercise sometimes felt so different from one day to the next.
This is a story about uncertainty as much as diagnosis
This chapter is about what happened to me after stroke and PFO closure: what I felt, what doctors investigated, what the monitors showed and how my understanding changed over time.
It is not intended to diagnose somebody else's palpitations or explain what treatment they should have. AFib and atrial flutter are medical conditions that need individual assessment.
The proper rhythm recordings and cardiology interpretation mattered more than what I feared was happening.
The rhythm story came after several other chapters
Stroke at 44
My cardiovascular investigations began because of the stroke itself. At that point I did not know why it had happened.
A PFO was discovered
Further investigation identified a patent foramen ovale, which became an important part of the search for an explanation.
My PFO was closed
I underwent PFO closure and hoped that might draw a line under the cardiac side of my stroke story.
Then rhythm questions appeared
Exercise began to feel different and heart-rhythm monitoring became another major part of my follow-up.
I expected the story to become simpler
After my PFO closure, I hoped I could move forward without constantly wondering about my heart.
I returned to exercise and wanted to rebuild fitness. Instead, harder cardiovascular work began to feel less predictable than it had before.
“I thought one chapter had been dealt with. Then another one appeared.”
Exercise suddenly felt different
I first noticed the change when I returned to running after the PFO closure, but it was not limited to running.
My cardiovascular tolerance simply did not feel as predictable as it had before. I could be moving comfortably and then suddenly feel as though my body had shifted into the wrong gear.
I knew what my previous fitness had felt like, so the difference was obvious to me.
At that stage I did not know whether I was dealing with lost fitness, something related to my previous treatment or a separate heart-rhythm problem.
ECGs, Holter monitoring and the loop recorder
A doctor eventually raised the possibility that atrial fibrillation or atrial flutter might be involved.
That led back into the world of heart monitoring. ECGs gave snapshots of my rhythm, while longer monitoring helped build a broader picture.
I also had an implantable loop recorder that had originally been placed as part of the investigation following my stroke.
One day the hospital contacted me because the recorder had captured a high heart rate. They asked what I had been doing at the time.
I had been out running.
Why longer monitoring mattered to me
A single heart-rate reading could show that something unusual had happened, but it could not explain the whole rhythm pattern.
The loop recorder, ECGs and later Holter monitoring gave my cardiology team information over time — which became far more useful than trying to interpret every individual sensation myself.
I still have my old loop recorder
Eventually the loop recorder's battery reached the end of its life and the device was removed.
After carrying it under my skin for years while doctors tried to understand why I had suffered a stroke, I decided to keep it.
It probably sounds strange, but to me it represents an extraordinary period of my life: stroke, investigation, uncertainty and the search for answers.
“I'd still like to have it framed — almost an Iron Man-style reminder of everything my heart and I have been through.”
Recently, I became convinced things might be getting worse
More recently I became much more aware of my heartbeat. I also felt more tired and found my tolerance for sustained cardiovascular exercise unpredictable.
What confused me was that this did not translate into a simple loss of all physical capacity. I could still complete substantial resistance training and strength work, yet some cardio sessions felt dramatically harder than I expected.
That inconsistency worried me. I began wondering whether AF had become permanent and whether I was seeing the beginning of a rapid decline in my fitness.
The next round of clinical testing gave me a more nuanced picture.
My watch and my symptoms could tell me something was happening — not exactly what
When you already know you have a heart-rhythm problem, it is very easy to start interpreting every heartbeat, exercise session or change in energy.
What I could feel
Greater heartbeat awareness, fatigue and unpredictable cardio tolerance were real experiences.
What I feared
I interpreted those changes as possible evidence that AF was becoming permanent and my physical ability was deteriorating quickly.
What testing added
Longer rhythm monitoring and an echocardiogram gave my cardiologist information that symptoms and individual home readings could not.
The picture became more specific
After a recent 24-hour Holter, the interpretation I was given was that atrial flutter appears to be the dominant rhythm, with atrial fibrillation occurring in the background.
That was important for me because it was not the simple picture I had built in my head from symptoms alone.
I also had an echocardiogram, which was reassuring and did not show the structural deterioration I had been worrying about.
None of that means there is nothing to deal with. I still have an arrhythmia and treatment decisions ahead. But it changed the way I understood what had been happening.
What I am deliberately not claiming yet
- I do not yet have the written cardiology report.
- I am not publishing that this is definitely typical CTI-dependent flutter.
- I am not quoting a personal ablation success rate.
- I am not making technical claims about how my PFO closure device affects treatment.
I will update this story when the written clinical detail is available.
I learned that the names are related — but they are not interchangeable
Atrial fibrillation and atrial flutter are both abnormal heart rhythms arising in the upper chambers of the heart, but they have different electrical patterns.
They can also occur in the same person. That matters because simply saying “I've got AF” can sometimes hide a more detailed rhythm picture.
The main SHF educational page explains the stroke connection and the difference in more detail. This chapter stays focused on what happened to me.
Flutter ablation has now been recommended
Following the recent monitoring and cardiology review, my cardiologist has recommended proceeding towards an ablation aimed at the atrial flutter.
That is a significant change from where this chapter previously ended, when cardioversion and possible ablation were still being discussed more generally.
I still want the precise diagnosis and proposed procedure confirmed in writing before I describe the technical details publicly.
So this chapter has moved forward — but it still does not have a final ending.
What I know today
- The recent echocardiogram was reassuring.
- The recent Holter suggested flutter is the dominant rhythm.
- AFib appears to be present in the background.
- Flutter ablation has been recommended as the next treatment direction.
Apixaban remained part of my own treatment
One of my frustrations after the PFO closure was that I had hoped I might eventually be able to draw a line under the medication associated with stroke prevention.
As AFib and flutter became part of my medical picture, anticoagulation remained part of my own treatment plan.
Decisions about anticoagulants, rhythm treatment and stroke prevention need to be made individually with an appropriate clinician.
Waiting for answers can become a story of its own
What surprised me during this period was how quickly uncertainty could become certainty in my own mind.
A few difficult exercise sessions and increased awareness of my heartbeat became, in my head, evidence that my heart was deteriorating and that my active life might be shrinking.
The tests did not tell me that everything was perfect. They did something almost as useful: they replaced some of my assumptions with better information.
One lesson I would keep
Symptoms matter and should not be dismissed.
But the story we build around those symptoms can sometimes run ahead of the evidence.
For me, proper ECG monitoring, an echocardiogram and cardiology review gave a much more useful picture than repeatedly trying to diagnose my future from individual sensations or watch readings.
AF/flutter changed my training — but it did not end it
The unusual part of my experience was that harder cardio could sometimes feel poor while resistance training remained comparatively strong.
Over time I shifted more of my training towards strength, functional work, walking and forms of cardio I could manage more predictably.
That deserves its own chapter rather than turning this page into a second exercise article.
Recovery can involve getting better information as well as getting fitter
Symptoms deserve attention
Changes in exercise tolerance and heartbeat awareness were worth investigating rather than ignoring.
Monitoring adds context
A single reading or one bad session could not explain the rhythm pattern my cardiologist needed to see.
Fear can outrun evidence
I had already imagined a rapid physical decline before the latest tests gave me a more nuanced picture.
Different capacities can coexist
Poorer cardio tolerance did not mean every part of my fitness had disappeared.
The diagnosis can evolve
“AF/flutter” was initially a broad label in my own mind. Monitoring gradually produced a more specific picture.
The story is still moving
A recommended next treatment is not the same thing as having the whole journey resolved.
AFib, flutter and my story — FAQs
Are atrial fibrillation and atrial flutter the same thing?
No. They are both abnormal rhythms involving the atria, but their electrical patterns differ. A person can also experience both.
Did my symptoms tell me which rhythm I was in?
No. I could feel changes in heartbeat awareness, tiredness and exercise tolerance, but proper rhythm monitoring was needed to give my cardiologist a clearer picture of what was happening.
What did my recent Holter show?
The interpretation I was given was that atrial flutter appears to be the dominant rhythm, with atrial fibrillation occurring in the background. I am still waiting for the written report and am not publishing a more precise rhythm classification yet.
Was my echocardiogram abnormal?
The recent echocardiogram was reassuring. That was important to me because I had been worrying that my changing exercise tolerance meant my heart was deteriorating structurally.
Am I definitely having flutter ablation?
Flutter ablation has been recommended by my cardiologist as the next treatment direction. I am waiting for the written clinical detail before publishing technical claims about the precise rhythm or procedure.
Does my experience mean somebody else's palpitations are AF or flutter?
No. Palpitations, tiredness and reduced exercise tolerance can have different causes. My story should not be used to diagnose another person's symptoms.
My story is not a substitute for cardiac assessment
AFib and atrial flutter can cause symptoms such as palpitations, tiredness, breathlessness or reduced exercise tolerance, but symptoms alone cannot reliably identify a particular rhythm.
ECG-based testing is used to assess heart rhythm. If you have new, persistent or worsening palpitations or other concerning symptoms, seek appropriate medical advice.
Call 999 for urgent symptoms such as severe chest pain, fainting, or symptoms that could indicate a stroke or another medical emergency.
Trusted further information
British Heart Foundation – Atrial fibrillation vs atrial flutter
This page describes Neil's personal experience of stroke, PFO closure, atrial fibrillation, atrial flutter and cardiac investigation. It does not provide diagnosis or individual treatment advice.
About this page: Written from lived experience by Neil — Founder of Stroke Health Fitness. Neil is not a doctor, cardiologist or cardiac physiologist. Latest story update: September 2026.
Exercise, AFib & learning to adapt
The rhythm problem changed the way some forms of exercise felt, but it did not remove training from my life. The next chapter is about how I changed my approach to cardio, built more strength and learned to judge progress differently.