Asymptomatic A fib, and use of a monitor watch and starting eliquis

@stryker66 and others...

Read that many of the LAA closures were being found to be leaking... and that their success rates were being inflated. This is the identical situation I've seen with AF ablations in general... with many patients having to undergo multiple "touch-up" procedures (additional ablations). The best recommendation, IMHO, is to consult an electrophysiologist that's done thousands of ablations through the years... and who TRULY has a significant success ratio. This procedure isn't easy to get right... it's very complex and difficult to perform so that sinus rhythm (normal / regularly-timed heart beats) returns... and REMAINS... for a considerable period of time after the procedure.

All the best to all!

/LarryG

@healthconscious
My electrophysiologist (EP) at Mayo Jacksonville advised me when you have sustained AFIB and not just in out they want to put you on blood thinners. I was put on Eliquis couple of months ago.

Regretfully recently started having a ton of AFIB episodes and glad I have the Eliquis. The drug is there to help prevent blood clots. Your EP should have told you the biggest risk of AFIB is strokes caused by blood clots. They are doing the right thing for you.

Request some feedback. I have had a ICD/Pacemaker since 2006. Most of all my irregular heart beats were PVCs and PACs.

Recently I was put on Eliquis after for first time sustained AFIB that lasted 4 hours. Don't remember it but I sure do now. I have off and on episodes of AFIB that I clearly feel both physically and mentally.

Some are very weak irregular heart beats that can last for many hours. Others like sustained high pule rate around 120-130 that last about an hour and go back to normal. I just was hospitalized for ICD shocks and thus much more focused on heart even though told not to do. It seemed the AFIB episodes started after hospitalization at least the type ones I have having now as prior was unaware of them.

I am asking for ablation. They did a Holter monitor and yup during the 48 hours did not experience either type of AFIB.

Have others gone through this? What do you do during AFIB episodes? Psychologically I am a mess, Physically I am just very tense and really don't like the feeling.

@jc76 I can only answer for myself. My nature has always been one of inquisitiveness, or curiosity. We had an older gentleman friend of my parents back in the early 60's who, when he would see my parents out 'n about, would ask, 'Where's How Come?' It was my calling card. I would pepper all grownups with, 'How come?' I read. All day long. Research, cross-referencing, looking for contradictions, looking for shared information that seems legit, and then formulate a file of knowledge. Fortunately, at 73, I'm not so rigid that I can't be made to either shut up or to change my mind. 😀

I have to know all I can to make decisions that don't complicate my life..............or ruin it. When I developed AF eight years ago, I began to read. I still read. I strive for consistent, reliable, and veridical information. I can't just read one NIH or JAMA article and be satisfied that this is the Great Truth. God knows that the medical community has all kinds in it, and they don't all agree on everything. So you hafta pay attention to changes in the winds....by reading multiple sources.

So, you ask what others do? I pace. I read. I talk it out. And once I understood the AF science, its mechanisms, and what ablation can possibly do if done well, it became my one solid hope, and I began to push for it. It took two ablations, same gentleman surgeon, before he nipped the AF, and I am happily about to go into my 38th month in blissful and consistent NSR (normal sinus rhythm). As a patient who was horribly symptomatic, I got little relief from cardioversions and never was prescribed AADs (anti-arrhythmic drugs), and living while in AF, which was coming on more and more frequently, lasting many hours, was horrible.

You can also experiment. With diet, with forms of exercise, with Vagal tone modification, improved sleep, ruling out obstructive OR central sleep apnea (and for God's sake get on that right away if it's a problem...it just increases your slide toward dementia and further heart deterioration!), etc. IOW, put your mind to work at finding relief for yourself. Knowledge is power, and you'll be able to relax more knowing................stuff. Especially when what you learn matches what your cardiologist and EP propose for you.

@jc76 Fortunately most of my A-fib episodes don't last very long these days ( many are less than 1 minute) so I just wait them out, keep on keeping on with what I am doing, and ignore them otherwise. But I can entirely sympathize with your feeling like a mess psychologically and physically too, when you're in A-fib and wondering how long this will go on. I've had a few longer ones and felt that way too. Admittedly the few hours-long A-fibs or Flutter I've had have driven me bonkers, others I didn't even feel but were reported by my pacemaker monitor.

Hopefully your docs will agree to an ablation for you, but in the meantime, it may be that medication will help to keep those A-fibs at bay? I take a heart rate control drug- metoprolol which does a decent job at keeping the heart rate down, diltiazem is also used for this purpose. There are also antiarrhythmic drugs which are intended to keep the heart in normal sinus rhythm, you can discuss that with your doctors to see what your options are and what's best for you.
Well, as for those arrhythmias not showing up on your Holter monitor report- those are notoriously intermittent and according to a corollary of Murphy's Law they won't show up when you're looking to document them- either in an office EKG or an extended monitor! Doesn't mean you don't have them or they won't come back at the most inconvenient time, and the doctors know this.

But if you have an ICD/pacemaker device and have at home monitoring capability ( either automated remote or manual where you send a report via phone or internet) your A-fib episodes may have, or can be sent to your doctors and documented in your records. I think they call these intracardiac readings from your pacemaker EGMs, but they can also be graphed and will show the type of rhythm that's occuring- or so I am told.

@marybird
Thanks for taking time and very helpful.

I don't think so many people know how life changing they can be and I say this also for medical professionals who have not suffered with them.

I cannot take any medications that are to lower my HR. My pacemaker paces me at 70 bpm because my normal rate with medications I am taking would be in low 50s.

You are right with Murphy's law. I had a Holter monitor for 48 hours and not one AFIB or VFIB. The problem I have addressed with pace clinic is the fact they had my theresold for reporting a tachycardia was set at 160 bpm and I had several at 140. So they did not see them on notification nor were they sent. So I said okay programming wrong or device not working because I know I had a VT.

Then they call back and say we checked the strips and yes indeed you had a VT but was below reporting so they changed the number. Then I have a ton of noise on one of my atrial leads. That causes the device to read AFIB. So they years ago lowered the sensitivity. So now when I was getting all those AFIB episode the device was not reporting even though I was having them. So I had they changed the sensitivity to report them only to cause another problem. When atrial are beating fast the device tries to bring ventricles up to match rate. That causes me to feel a racing pulse. So I can't find a way to solve both so have to live with it.

Thanks again!

@gloaming
I have been pushing for ablations and finally they said the plan was to them. However we were talking about PVCs back then not AFIB. I would rather do if first for AFIB as far more of an issue for me both physically and mentally than PVCS.

I have been reading about the correlation with Vagus nerve affecting this condition a lot.

Boy I hope I get to what you have now of 38 months of NSR. I have cut my meals to 1/2, sit up straight, walk around after eating, don't drink water with meals. A.I. came back with flexing thighs, breathing out slowly, etc. So I try everything to prevent or reverse them when occur. I just don't think medical profession knows how horrible this is both physically and mentally.

@jc76 I understand your doubt about the medical system really 'getting' what AF is like for those of us who are made so miserable by it. However, as was very carefully explained to my by my now-retired sis-in-law, a former oncology nurse, much, or really most.....of all modern medicine is about symptom management, mitigation, or reduction. We don't have all the answers or corrections for every known condition, but we can make the patient more comfortable. This is what 'palliative' means....getting a strong grip on symptoms, pain, and deterioration....and striving to keep them from getting worse.

For AF, the science seems quite firm and resolved: it won't kill you. Neither will PACs and PVCs. Not at first, not soon. Instead, it takes some evolution, some progression, to where their numbers creep into the 2000-4000 beats per day range. Remember that your average healthy heart beats about 90K times each day. So, somewhere between 2000 and 4000 beats in a day represents something close to that 3% 'burden' mark where the literature I have seen says morbidity becomes a concern................................becomes.............................not IS. The point being you begin to discuss options with the patient when the burden signifies a possible change that is undesired.

You have a lot of sympathetic and understanding friends here, even if they aren't horribly affected by their arrhythmia(s).................................................................................lucky sods. 😀

@jc76 I am "fortunate" to have dramatic SVT episodes (180-20+ bpm) rather than Afib, but the bottom line is that whenever svt strikes at that rate, it is AWFUL too! My svt exploded from easily managed to out of control in Nov 2025.
I also have been fortunate that my cardiologist understands completely and got right on top of it; and the ER staff are very compassionate each time I show up because standard at-home interventions no longer worked. But the outside world can't see or feel what we are feeling and thus don't necessarily understand the reality or urgency, not to mention the effect on our quality of life!

My story looks lie it's going to have a happy ending. Four ER visits in 3 months provided excellent EKG evidence. My cardiologist got me to a good electrophysiologist. He took one look at the ER records and got me scheduled for an ablation in exactly 13 days!

I am 4 days post op and and beyond relieved. Dr is extremely optimistic that he knocked out the offending cells. I don't think I realized just how anxious and stressed out I've been. I know Afib is so much harder to deal with, and I truly wish for all of you the same level of success that @gloaming is experiencing.

@osgilian That's great news! I've had my share of SVTs throughout the years, along with the A-fib and flutter ( multi-talented heart, I guess.....) still get the SVTs so I can attest to how badly they can make you feel. Comparing the "misery" factor between SVT, A-fib and flutter in my opinions, it'd all be a tossup. My symptoms have always been very similar for each of these arrhythmias, none of them are any fun. I still get the same shortness of breeath, lightheadedness and if it goes on for some time, some chest pain that feels to me like a "stitch" in the heart muscle from racing over time ( similar to the stitches in our sides we'd get when we ran for a long time as kids).

My cardiologist, who gets my pacemaker monitor reports, tells me they see both SVT and A-fib on the reports. Interestingly enough, the heart rate during SVTs is higher than it is for A-fib, with the SVT being around 170 BPM and the A-fib around 130.

From what I've been told over the years, having a greatly elevated heart rate over time can cause "tachycardia-related cardiomyopathy" - damage to the cardiac muscle, and that's also an important factor in considering ablation and other treatments to correct the tachycardia. There are a couple of SVTs that involve aberrant electrical pathways, ( ie, AVNRT- AV node re-entry; ) may be genetic in nature ( Wolffson-Parker-White-WPW) where the aberrant pathway is well known and can be ablated which often results in a "cure" for these types of SVT. Far as I know these SVTs are not associated with abnormal clot formation so patients with these arrhythmias don't need to consider taking a blood thinner as they might with A-fib.

As I understand it, A-fib is associated with many factors which must be considered in treatment of this arrhythmia. Ablation can be and often is successful but there are other medical issues that may well make the A-fib recur. Its association with abnormal clotting and stroke risk make it more complicated to treat than another SVT in an otherwise healthy heart. I don't think of A-fib as "worse" or any reason to minimize the symptoms and issues associated with other SVTs, just more complicated to deal with, perhaps. And of course A-fib dominates the literature in the field of cardiac electrophysiology!

Anyway, I'd never ever be one to minimize the symptoms or problems you had with your SVT, I know how lousy it makes you feel, affects your lifestyle, and it can affect your heart adversely if it goes on long enough and your tachy burden is high. So high fives to you and many best wishes that your future will now be SVT-free!