Heart Rhythm Conditions – Welcome to the group

Well I just went two years and three months without afib and once again dialed 911 and ended up in ER overnight. Stress of moving?

My pulse was 184 with afib, shortness of breath, faint, chest pain. Troponin was going up so they kept me there: it reached 10 which is above normal. I also have a long QT interval at 460, Blood pressure was lowish after diltiazem but stabilized.

Have to see cardiologist for the big picture. No blood thinners as yet. I feel that something else is wrong. Usually I recover after an episode and this one was short, under an hour. But I am a little short of breath and my chest feels wobbly so to speak. I have a Kardia and I am in sinus rhythm.

I overheard something about "depressions" on the EKG and have to ask about that too.

Usually a rate above 140-ish is going to be flutter. AF can be between about 140 all the way down to 80, if you can believe it, but a proper 12 lead ECG is needed to determine so.

IF this happens increasingly more often, and I'm afraid the research suggests it is highly likely in all patients (AF is a progressive disorder pretty much always), you might wish to acquire a modern smart watch that can produce a rudimentary ECG. If there is AF going on, your watch will detect it. Then, you can download the record and paste it into your files and attach it to an email or an SMS to your cardiologist.

It is good that you self-revert before long. This means you're still in the paroxysmal stage of AF. It can last years. I got about four out of mine before the frequency and duration began to climb and I needed the intervention of a highly skilled, highly experienced, and very busy electrophysiologist (EP). The wisdom in the field is that you want to get control, either with medicine or with catheter ablation, while still in the earliest stage, that being paroxysmal. It becomes increasingly hard to win the battles as one progresses to persistent, and finally to permanent, AF. So my advice is to see at least a cardiologist now, and to ask about NOAC's (Novel Oral anticoagulants) to keep your risk of stroke low. What people forget, or never learn, is that a stroke from an arrhythmia, particularly AF, is high for even weeks after even a short episode. The reason is that a clot can form in the left atrial appendage and get dislodged some time after it has formed. When it gets pumped out of the atrium, into your left ventricle, and then into the left arterial descending (LAD), or into your brain................

My heart is in afib, not flutter, with heart rate 180+.

I had episodes once a year, starting in 2015, perhaps not coincidentally while on a cancer med. Once I got off the cancer med, I went 2 1/4 years without any afib, so mine is not worsening, and the episode last week was very brief. I am not concerned about a clot after a brief episode and neither is my doc. With a longer episode, they do an echo to check for clots. That's the best they can do until they start prescribing short term anticoagulation.

I have now had 8 episodes of varying length but the trend is toward fewer and shorter. I cannot take meds due to low blood pressure and certainly don't need an ablation.

I have a Kardia Mobile and have worn a Holter monitor for a month. It confirmed that I always feel afib and that I don't have it except during one of these episodes.

I sincerely hope you continue to improve, and that in a few weeks you won't look back.

Hi My name is Cathy, age 74, and I have a complex cardiac history that includes Pulmonary Venous Hypertension, Atrial Fib, Atrial Flutter, SVT's, PAT's and persistent Atrial Tachycardia that started in 2009. I've since had multiple cardioversions and 3 ablations which ultimately caused Stiff Left Atrial Syndrome that was diagnosed at the Mayo clinic 3 years ago. I had a Watchman device and a bi-ventricular Pacemaker placed in 2017. I have moderate to severe CHF with preserved ejection fraction. The Docs say that my tricuspid and Mitral valve are both moderately regurgitating and my pacemaker leads have tethered themselves to my Tricuspid valve so there's no way to fix my valve unless they replace it. My cardiac meds include Torsemide for fluid management, dofetelide for rhythm control and metoprolol for rate control.
So now I'm just trying not to let the shortness of breathe and all of the other age related conditions depress me too much and hope that the Docs can figure out a way to extend my life expectancy and most importantly, still have an acceptable amount of quality of life.
I've looked on Mayo Connect and as yet have not found anyone that has been diagnosed with SLAS or Stiff Left Atrial Syndrome. My doctors at Mayo Clinic in Jacksonville were able to diagnose it and told me that it is relatively rare but is known to be caused by having had multiple ablations for Afib and Flutter. If you have had 3 or more cardiac ablations or are considering additional ablations, talk to your cardiologist about this under diagnosed complication.

Cathy, thanks for sharing your experience, and I can sympathize with your condition, even if I am not in it. There is a member calling herself SusanD on affibbers.org forum who has a truly horrendous history, and she's still kickin'. In fact, I think she just moved from the USA to Great Britian...but not certain. Anyway, after literally umpteen interventions, and living at an ER for weeks at a time over the past four years, she is home with a permanently destroyed AV node and SA node and she has a pacemaker.

As Carey, the moderator on that forum warns people repeatedly, and he had six ablations over about four years, you MUST find the very best EP around and get on that person's schedule. There are scores of good EPS here and there, but the more difficult cases must get on the lists of the best in the business, even if it means travel.

And yes, pulmonary vein hypertension is a problem with some patients, especially after heavy catheterization. This is why the Pulsed Field Trials are under way, and newer methods are being tested all the time to avoid damaging the aesophagus and the Vagus nerve.

I can't tell you how many excellent EPs there are in the USA, quite a few, but the one we urge people to contact is Dr. Andrea Natale at the Texas Cardiac Arrhythmia Institute in Austin. He was trained by the vaunted Dr. Pierre Jais in France, and he continues to train many highly competent EPs.

Cathy, I was fit all my adult life. I don't know how well I 'lived', but I think I ate reasonably, don't smoke, don't drink much at all, and I was a competitive runner with a rest heart rate of about 42 BPM. One day, at the end of a 10Km 'garbage' run, meaning just getting a run in, no goal or training in mind, I felt weak and my legs felt like lead. Turns out I had commenced a history of AF. After multiple tests of all kinds, all that was left was to go to an overnight sleep lab. Bingo! I had apnea....and not just mild or moderate, but severe! My heart had finally thrown up its hands and said, 'Fine, if that's the way it has to be, I'll stop playing nice.'

Again, thanks for your informative post, and for sharing what must be a worrisome existence. I hope you find relief.

Thanks for the great info! I've had Cardiologists who blame everything on my lungs (former smoker) and Pulmonologists who blame it all on my heart. If I could have just gathered them into a single room and let them duke it out, I might have had a better outcome, LOL!! Medicine has become so micromanaged, it's hard to find Doctors today that will look at the WHOLE patient, not just the area of concern related to their specialty. I see my primary cardiologist this week and will see if he has any new insights and answers to my long list of questions that I manage to have for him at each visit. So far sleep apnea is the only problem I don't have... yet! Thanks again for the info re Dr Natale and the Pulsed Field trials. As patients we really need to be our own best advocates in order to obtain the best outcomes! And to also stay positive through it all!

Hi Everyone, I just read a comment about monitoring your cardiac rhythm at home on smart watches and devices like Kardio. I just wanted to pass along that if you have a Pacemaker, those devices will NOT work to identify an arrhythmia!! The pacemaker's signal interferes with the watch or external device as it seeks to recognize whether you're in Afib. I called Apple and they said that the fine print actually states that. So much for reading the fine print!!
Please don't purchase a device just so you can self diagnose an arrhythmia. When in doubt, call 911 or your cardiologist for instructions. I love my Apple watch, but I loved it more when I didn't have a pacemaker. Maybe in the future Apple or some other tech company will figure a workaround! Remember, If you don't feel well, call 911!!

Just spent 3 days in hospital for AFIB. They had a hard time getting my heart rate down. So they sent me home with amiodarne 200mg. I am thinking of doing the ablations. Have appointment with cardiologist next week for that conversation. I had the Watchman put in ittle over 2 years ago. Have had minor AFIB episodes since then until this last weekend. Palpitations (hard pounding ones) with heart rate of 127. Primary care did an EKG and sent me to ER. This episode scared me a lot. So now I have to do the very thing I was avoiding.....ablation.

My fervent hope, phoenix, is that you look back in a couple of years and marvel at how easy it all was, and that you have peace and calm, and that you can sleep, and that you experience no more palpitations after your ablation. I have had two separated by about seven months. It has been bliss since the second. I went from a slow spiral downward to my first, or index, ablation, but I was in the local ER only six short days later. I, too, was put on Amiodarone for about eight weeks. I had a good period of grace for the next three months, but I was in the ER starting New Year's Eve, and presented there each of the next three days with AF. Three cardioversions lasted between 16 hours and 20 minutes, with the reduction going successively.
Ablation is not a cure, unfortunately, but it can put you into a remission of sorts. Even if you only get 24 months of respite, you'll agree that the ablation was entirely worth it. In the hands of a truly capable electrophysiologist, you'll get several good years, even a decade, before you must return with newly established AF. This is not an absolute; not every single case devolves into a resumption of AF, just a whole lot of them. The best EPs will take a second crack at you, and often, about 80% of the time, this buys you another long stretch of time AF-free.
Please don't fret about an ablation. In good hands, the procedure works, and you'll go on with your life. You won't need metoprolol or other channel blockers, and some EPs will even let you stop taking anti-coagulants if you settle into a prolonged period with no more AF. This is quite common with a Watchman implant to close off the atrial appendage because that's where a huge chunk of the risk of clot-formation lies. Once that is done, your risk of stroke when out of AF lies only in other co-morbities...if you have any. That includes aging, though.

Good luck!