Thanks
Cardiologist (Heart Specialist)
I would be concerned about your documented 1:1 conduction of flutter and at the very least would want you on a beta blocker or calcium channel blocker to prevent such rapid conduction. There may be a case for flutter ablation. This is a fairly simple and safe procedure which could eliminate the 300 bpm and may also stop fibrillation in your case. The applicability of this in your case would be easily determined by seeing the ECG documentation of the flutter during the stress test. I presume you've had an echocardiogram.
Your risk of stroke is not defined by how much rhythm disturbance you have but rather by your CHA2DS2VASc score. Aspirin has no real role in protecting you. If your CHA2DS2VASc is 2 or more then you should be considered for warfarin or one of the new oral anticoagulants, regardless of how your arrhythmia itself is managed.
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