VTach vs Afib

One way for the experts (not me) to tell is to place you on a 12 lead ECG and then to inject you with a measure of adenosine. It feels awful, like a feeling of dread or of doom. It is gone inside of a few seconds, so it's quite bearable. They should warn you of this sensation before they administer it. It slows the heart, allowing those looking at your heart rhythm depicted on the screen to see if it's flutter or atrial fibrillation (AFl and AF respectively).

Unfortunately, AF is a progressive disorder. And also unfortunately, one of the outcomes is a thickening of the atrial wall. Sometimes this thickening can encourage mitral valve prolapse, or it can lead to heart failure (I prefer the term 'cardiac insufficiency' because the heart doesn't really 'fail'.)

If your heart rate exceeds 100 BPM for more than about 24 hours, you need attention. You may need a pacemaker at this point because you sound like you are in the last stage of AF, that being 'permanent.' AF begets AF, and when you're in it too long, you'll evolve into persistent and then permanent...which I think is where you might be. The heart does tire, especially with a high rate, and when the high rate reduces the oxygen perfusion around the body and in the heart itself. So, if you are not already under close watch by a cardiologist or an electrophysiologist (cardiac electrician), you must go to see one ASAP. Please.

Final note: VTach is normally deadly. Nobody lasts long in VTach. I wonder if you are not in supraventricular tachycardia (SVT). SVT covers several upper chamber arrhythmias, including AF.

@jnjetsman does the CRT-D device handle V-tach? It sounds like it does not mitigate afib. I looked it up because I don't know much about these devices and had questions. I also thought that V-tach was dangerous so wondered if the device protects you in any way or if it is, as @gloaming suggested, actually SVT.

Do you have a smartwatch or Kardia device to assess whatever arrythmia might be going on? So sorry for what you are going through.

Sorry to read about your situation. I have had one ablation, still have v-tach. The CRT-D definitely works for my v-tach. Mine are relatively slow (< 160 bpm). The CRT-D paces me out of the v-tach with no “big shock” thankfully. I also have an apple watch but sometimes the v-tach is too short in duration for it to be caught by the watch. I do credit the watch for probably saving my life when my irregular heart rates first started.

Well I'd say go get an ekg or Karida and not guess at it. Although the Kardia is good it is not spot on. I've had plenty of "possible Afib" reading and it wasn't Afib.
If you are dizzy then something is going on and nobody here can guess something like that.

I agree with the other commenters. I’d contact your cardiologist and ask for a referral to an Electrophysiologist as that is the specialist for dealing with batch, aflutter and afib, I believe. My husband had an non-ST elevation myocardial infarction (NSTEMI) with complication in 12/20. As they were bringing him out of an induced coma he began vtach, the longest being over 30 minutes(at least 3 but all in CICU so caught and CPR started immediately). Within days an ICD(implantable cardioverter-defibrillator)was implanted and vtach became controlled and all 3 monitored. He was also put on amiodorone for the afib/flutter and we along with his cardiologist received a report every 3 months as to occurrences of the 3, how long each lasted and any adjustments made due to it). He has never had to be shocked but a Walkman(blocks clots traveling to brain)was implanted in his right ventricle in 12/23 due to falls from orthostatic hypotension, etc. He is being treated at the Cleveland Clinic main campus.

The device, a 'watchman', is a device implanted in the left atrial appendage, not into the ventricle...as far as I know. It's role is to cause endothelial tissue in this grotto-like knob at the extreme upper left of the left atrium to grow into and around it, thus effectively 'mortaring' off the access of blood to that appendage. The appendage presents the greatest risk of clotting because blood flows poorly inside of it at the best of times. When in an SVT like atrial fibrillation (AF), the blood circulates even more poorly and can even begin to clot. A clot dislodged from the LAA and into the flow can find its way into the heart's own blood supply, into the lungs, or into the brain. Whichever place it gets to first, it's bad news.