1. < Heart Rhythm Conditions

Afib with Rapid Ventricular Response

Posted by Soliloquized @soliloquized, Dec 16, 2018

Lifelong history of PVCs, limited PSVT (brief), PACs, and almost had an ablation for PVCs. The almost ablation came after eating a bag of chocolates (with others, not the whole bag), resulting in persistent PVCs for months. Doctor gave me Acebutolol 200mg three times a day and the PVCs slowed and stopped. 

Years passed by, no irregular rhythms of note, then a few weeks ago, I jumped out of bed, having just got into it. The heart rhythm was irregular, I tried the Valsava Maneuver, didn't work. Phoned for ambulance, transported, told afib, spent 4 days in the hospital. Told I was to get an EchoCardiogram the following day, they did nothing. At 10 PM I overhear the nurse say I'm getting an Adenosine Stress Test in the morning. I told them no. No one talked to me. I told them I want rate control and anticoagulation in place, I'll see my own doctors. 

The day I thought I was being discharged, I got a Definity Contrast EchoCardiogram. I had one last year. A very well known cardiologist read it, he said it was identical to last years, except I was in afib. My heart rate during the test? 160, they only gave me 25 mg Metoprolol Tartrate several hours before the test, I am now on 200 mg AM and 100 mg PM of Metroprolol Succinate.

On Acebutolol, my resting heart rate was in the 50s, and after 5 minutes on a walking stress test my heart rate was in the 90s. Ejection fraction is 65% before, and since, the afib began. 

Can someone comment on the ventricular rate, is this common with afib? I'm on Metoprolol Succinate and Coumadin. If I get anxious, I get some fast ventricular beats, short runs, I can feel them in my pulse. I'm waiting for a month of anticoagulation to be in place at therapeutic levels, and the cardiologist wants to try a one time shock conversion. He claims it's an outpatient thing, but wants to start Sotalol, from reading I understand a 3 day hospital stay is advised starting on that drug.

Remember, I was monitored for 4 days, 24/7. Neither my family doctor, an Internist, or my cardiologist, thought a stress test was necessary, and they had access to the same data. But this is unnerving to me, the afib thing, looking forward to hearing from others.

Though I'm in my early 60s, my son had three cardioversions (two by shock) for afib and mother had afib much older and ended up with a PaceMaker. The woman that did my EchoCardiogram during my hospital stay said afib tends to run in families.

Interested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.

Soliloquized | @soliloquized | Dec 17, 2018
In reply to @hopeful33250 "@soliloquized It could be that your cardiologist's not seeming concerned about your last EKG might be..." + (show)
@hopeful33250

@soliloquized
It could be that your cardiologist's not seeming concerned about your last EKG might be a good thing. Cardiologists have read a lot of EKGs and they know when to be concerned and when something is less than serious.

I know what I'm going to say is easier said than done but: try to relax. Find some way to occupy yourself and keep your mind and hands busy. Do you have any activities that you enjoy, like music, knitting, crafts, art, etc.? If so, try to focus on that. January will be here soon enough and the conversion attempt will happen and perhaps you will begin to find relief.

What can you do today to give yourself a break from your worry?

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Thank you. I've been heart obsessed all my life, I've had the darn things, two EPs were willing to ablate, but they weren't serious, but frequent. Anyone with them, when you first become aware, or if they markedly change, needs to see their doctor. But my wife worked for a cardiologist, they had patients with irregular heart rhythms that were so bad she couldn't get an accurate pulse, they'd get the heart rate from the EKG. The doctor came in, talked to the guy, took his wrist and asked him if he ever has any irregular heart beats. He said no. The doctor didn't tell him because he didn't want him to obsess about it, his heart was healthy otherwise.

A coworker in afib that returned to work with it that way. I took his pulse, OMG, it was all over the place. But his doctor cleared him to return to work, and the plant doctor cleared him too. I just didn't realize within 10 years (actually less) I'd be in the same condition.

Thanks again for the good advise.

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1 reply
Mentor
Teresa, Volunteer Mentor | @hopeful33250 | Dec 17, 2018
In reply to @soliloquized "Thank you. I've been heart obsessed all my life, I've had the darn things, two EPs..." + (show)
@soliloquized

Thank you. I've been heart obsessed all my life, I've had the darn things, two EPs were willing to ablate, but they weren't serious, but frequent. Anyone with them, when you first become aware, or if they markedly change, needs to see their doctor. But my wife worked for a cardiologist, they had patients with irregular heart rhythms that were so bad she couldn't get an accurate pulse, they'd get the heart rate from the EKG. The doctor came in, talked to the guy, took his wrist and asked him if he ever has any irregular heart beats. He said no. The doctor didn't tell him because he didn't want him to obsess about it, his heart was healthy otherwise.

A coworker in afib that returned to work with it that way. I took his pulse, OMG, it was all over the place. But his doctor cleared him to return to work, and the plant doctor cleared him too. I just didn't realize within 10 years (actually less) I'd be in the same condition.

Thanks again for the good advise.

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I'm sure this must be a very frightening disorder, @soliloquized. I hope that you are able to get the help you need. You have had a lot of heart problems and you deserve to get good care.

You seem to be content with your current medical team so a second opinion does not seem to be an option for you now, does it?

Take care and do your best to relax. Tension can make any health problem worse. I wish you well.

Will you keep in touch and let me know how you are doing?

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Soliloquized | @soliloquized | Dec 19, 2018

The plan is to increase my INR by increasing the Coumadin, do that for a month, then do the Electro Conversion without a Trans Esophageal Echocardiogram. I'll be started one day on Sotalol, Converted the next, then go home 48 hours after Sotalol is initiated if everything is OK. He only wants one attempt at the Electro Conversion. The one thing he mentioned I wanted to mention is that he said there is an area in the atrium, not the entire atrium, that causes the clots associated with atrial fibrillation, and that, through a complicated procedure, that area can be closed off, eliminating the risk of clots. He wasn't advocating it, just mentioning it. I've not read about that anywhere else, and the closer I get to being electro converted, the less I want to read about it. Originally I was told electro conversion was an outpatient procedure, and it is, but the initiation of the Sotalol requires a minimum of 48 hours in the hospital. Not complaining, just updating the thread.

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2 replies
Mentor
Teresa, Volunteer Mentor | @hopeful33250 | Dec 19, 2018
In reply to @soliloquized "The plan is to increase my INR by increasing the Coumadin, do that for a month,..." + (show)
@soliloquized

The plan is to increase my INR by increasing the Coumadin, do that for a month, then do the Electro Conversion without a Trans Esophageal Echocardiogram. I'll be started one day on Sotalol, Converted the next, then go home 48 hours after Sotalol is initiated if everything is OK. He only wants one attempt at the Electro Conversion. The one thing he mentioned I wanted to mention is that he said there is an area in the atrium, not the entire atrium, that causes the clots associated with atrial fibrillation, and that, through a complicated procedure, that area can be closed off, eliminating the risk of clots. He wasn't advocating it, just mentioning it. I've not read about that anywhere else, and the closer I get to being electro converted, the less I want to read about it. Originally I was told electro conversion was an outpatient procedure, and it is, but the initiation of the Sotalol requires a minimum of 48 hours in the hospital. Not complaining, just updating the thread.

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I appreciate your update, @soliloquized. Keep posting. Your information is very informative and helpful.
Will post again (and especially after your procedure is completed)?

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Martin Jensen, Volunteer Mentor | @predictable | Dec 19, 2018
In reply to @soliloquized "The plan is to increase my INR by increasing the Coumadin, do that for a month,..." + (show)
@soliloquized

The plan is to increase my INR by increasing the Coumadin, do that for a month, then do the Electro Conversion without a Trans Esophageal Echocardiogram. I'll be started one day on Sotalol, Converted the next, then go home 48 hours after Sotalol is initiated if everything is OK. He only wants one attempt at the Electro Conversion. The one thing he mentioned I wanted to mention is that he said there is an area in the atrium, not the entire atrium, that causes the clots associated with atrial fibrillation, and that, through a complicated procedure, that area can be closed off, eliminating the risk of clots. He wasn't advocating it, just mentioning it. I've not read about that anywhere else, and the closer I get to being electro converted, the less I want to read about it. Originally I was told electro conversion was an outpatient procedure, and it is, but the initiation of the Sotalol requires a minimum of 48 hours in the hospital. Not complaining, just updating the thread.

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@soliloquized, one technology for shutting off the open area in the atrium is called "Watchman." You can look into that by googling the word. Martin

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1 reply
Soliloquized | @soliloquized | Dec 19, 2018
In reply to @predictable "@soliloquized, one technology for shutting off the open area in the atrium is called "Watchman." You..." + (show)
@predictable

@soliloquized, one technology for shutting off the open area in the atrium is called "Watchman." You can look into that by googling the word. Martin

Jump to this post

Thanks much. Watched the video on it, apparently that's what the doctor was referring to. Interesting. Left Atrial Appendage. Just think, if not for that, Afib would be a lot less complicated.

Thanks again Martin.

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ilnapenny | @ilnapenny | Mar 17, 2019

Hello I was diagnosed in 2011 with Pheochromocytoma, Deep Vein Thrombosis - DVT and Congestive Heart Failure. I am currently still having health issues (Afib/Aflutter - heart rate sometimes at 180 -260), recurrent Pneumonia - Nov 2018, Jan 2019 and now Mar 2019) and overall just not feeling well. I currently have in a pacemaker (St. Jude's), had 3 unsuccessful Ablations and an adrenalectomy.
I am also currently under the care of an EP, a Cardiologist, Pulmonologist (for the Pnuemonia issues) and my GP here in Tx. I have done 2 CT scans, 2 chest xrays and a Upper GI series within the last (4) months. but I still have no definitive answers from the EP or Pulmonologist as to what is causing recurrent pneumonia, palpitations and just not feeling well physically. The Docs are quick to prescribe antibiotics, steriods and/or Zpack for the pneumonia which wreaks havoc on my body. I am currently on Xarelto 20mg and Rythmol (Propeferone) 225 mg 3x daily. I would like to get some help or talk to someone that are experiencing any/similar symptoms and what kind of help they have been receiving. Please help and let me know. Thank you so much....

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1 reply
Kanaaz Pereira, Connect Moderator | @kanaazpereira | Mar 17, 2019

Hello @ilnapenny

You may notice I moved your message and combined it with this existing discussion. I did this as I thought it would be beneficial for you to be introduced to the many members who are discussing much of what you are experiencing.
If you click on VIEW & REPLY in your email notification, you will see the whole discussion and can join in, meet, and participate with other members talking about their or their loved ones' experiences.

You might be interested in viewing these conversations on Connect, as well:

– Congestive heart failure- Overmedicated? https://connect.mayoclinic.org/discussion/congestive-heart-failure-overmedicated/
– Congestive Heart Failure https://connect.mayoclinic.org/discussion/congestive-heart-failure-1/

I’d also like to bring in a few members like @suscros68 @afrobin @thankful @predictable @bangel @archer @marlynkay @ch665296f @yoanne @badboys1965 @yorlik to share their thoughts.

REPLY
1 reply
ilnapenny | @ilnapenny | Mar 18, 2019
In reply to @kanaazpereira "Hello @ilnapenny You may notice I moved your message and combined it with this existing discussion...." + (show)
@kanaazpereira

Hello @ilnapenny

You may notice I moved your message and combined it with this existing discussion. I did this as I thought it would be beneficial for you to be introduced to the many members who are discussing much of what you are experiencing.
If you click on VIEW & REPLY in your email notification, you will see the whole discussion and can join in, meet, and participate with other members talking about their or their loved ones' experiences.

You might be interested in viewing these conversations on Connect, as well:

– Congestive heart failure- Overmedicated? https://connect.mayoclinic.org/discussion/congestive-heart-failure-overmedicated/
– Congestive Heart Failure https://connect.mayoclinic.org/discussion/congestive-heart-failure-1/

I’d also like to bring in a few members like @suscros68 @afrobin @thankful @predictable @bangel @archer @marlynkay @ch665296f @yoanne @badboys1965 @yorlik to share their thoughts.

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I sincerely thank you...

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1 reply
ilnapenny | @ilnapenny | Mar 18, 2019
In reply to @ilnapenny "I sincerely thank you..." + (show)
@ilnapenny

I sincerely thank you...

Jump to this post

Hello since I am new to this group discussion website. How do I go about finding out if I had any response to my question. Please let me know. Thank you...

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