Afib: What causes an episode? What if I don't notice?

Posted by dfelix @dfelix, Jan 27, 2019

yesterday I had episodes of afib. I was just laying down when my heart started beating fast. Over 100 beats per min, What are possible casues of these occurances?

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

@predictable

Hi @cadillac. Glad that Colleen invited me to join in this discussion so we can get to know you better. I think my a-fib is much like yours. I don't realize my irregular heart beat except in two situations — when my doctor is taking an EKG and when I'm taking my blood pressure. Otherwise, I am not conscious of my heart beat. How about you? Do you feel irregular beats? Would you remain anxious if you didn't know you are in a-fib?

I have had irregular heart beats for 25 years or more, but my a-fib diagnosis came only four years ago when it showed up on my EKG during my annual physical examination. Although I had no sense of the problem, I accepted the diagnosis by my personal care physician and had it confirmed by a cardiologist. We then agreed to two medications — Carvedilol, a beta blocker to smooth out and dial down my heart beat, and Coumadin, an anticoagulant to reduce the chance of blood clots forming in my atrium and getting sent off to sensitive organs like my brain or my kidneys. Would you share with us your current medication? Martin

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My doctor has me on Eliquis (a blood thinner). I also have high blood pressure and one of the drugs I take for that (Amlodipine Besylate) is said by some people to cause Afib. I also have kidney insufficiency and am taking drugs for that. I am wondering if the Amlodipine has caused my Afib since I have been taking it for some time.

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@predictable

@kates1221, I too have permanent A-fib brought on by high blood pressure and have been under treatment for it for more than five-and-a-half years. Troubling as it has been, I have never been frightened by my arrhythmic heart beats, because I have been under medical treatment for it since mid-2014. My confidence is probably bolstered by the fact that 1) I rarely feel my irregular heart beats (although they show up on my BP meter every time I measure my blood pressure), and 2) constant medical treatment has kept my fears at bay.

Treatment started with Coumadin to prevent formation of clots in my atrial chambers. At the same time, dampening my heart beats was helped, first, by calcium channel blockers and, later, by the beta blocker Carvedilol. My cardiologist (an electrophysiologist) is prepared to prescribe other medications that provide "cardioversion" to overcome irregular heart beats that are more threatening. He also described the surgical procedure, "ablation," that he'd perform for even more serious and resistant heart rhythm problems.

My main threats come from hypertension, chronic kidney disease, and stroke — not from A-fib or any other heart ailment. So in addition to a Cardiologist, my medical team includes a Nephrologist (treating BP and kidney disease), a Neurologist to deal with strokes, and a Pharmacy PhD who helps me manage my Coumadin anticoagulant.

I hope your conditions are not more trouble than mine. Would you mind sharing why your doctor feels there is no treatment for your A-fib? Have you had the chance to discuss with your doctor any of the possibilities that have helped me?

Martin

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@predictable. You should consider Eliquis to replace warfarin. You never know if diet or other factors move warfarin inr out of therapeutic range causing a mini stroke or worse. No constant blood monitoring needed with Eliquis so easier to be in safe range.

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@tdrohan

@predictable. You should consider Eliquis to replace warfarin. You never know if diet or other factors move warfarin inr out of therapeutic range causing a mini stroke or worse. No constant blood monitoring needed with Eliquis so easier to be in safe range.

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I have considered it @tdrohan, but chose to stay with Coumadin. One reason is that my HMO has a very good program for managing Warfarin medication use. I get regular blood tests to ensure that my level of anticoagulation remains within bounds. My mishap that resulted in my stroke is understood as to its cause, and I don't think that will happen again. Finally, an antidote is readily available in medical facilities across my area of the country, making it virtually certain that I won't bleed out from Warfarin. In contrast, there has been no antidote for Eliquis. Finally, Eliquis is focused on possible clotting problems from a short list of circulation maladies. Coumadin is more generic and used on a wider range of maladies. Martin

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@catmom777

BTW, I feel a hunger for oxygen also. I feel I cannot get enough air. I've felt that way for about a year. The doc thought it was because of my acid reflux. I'm tired a lot. I used to have so much energy that this is totally uncharacteristic for me. Once upon a time I worked/raised a family/did all the cooking & housework, and found time to sew clothes for myself and my girls. Now it's hard to get through the day. But, hopefully after I see the cardiologist I will have more answers.

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Just a suggestion. Could the not getting enough air be COPD? Chronic obstructive pulmonary Disease. Going to a dr. Like a pulmonary specialist. A breathing specialist. I know how a fib feels I was diagnosed couple years ago. I have been sleeping on a chair. But I do only get a couple hours sleep a night. I probably have sleep apnea but when I went for the testing twice they couldn’t get a reading because I don’t sleep. I’m so tired, I can hardly move at times. I also feel my a fib, sometimes tachycardia fast other times feel like skips and thumping out of my chest. Isn’t life grand. Lol. I’m grateful for another day of life. My best to you.

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@jimana

@dfelix, as you get more responses and do internet searches you will find there are many A-fib triggers but what causes the condition in the first place is still somewhat a mystery. In my case it seems to be caused or triggered by an excess of thyroid hormone. I have been hypothyroid (underactive thyroid, not producing enough hormone) to I have taken either Synthroid or a natural desiccated thyroid extract. If one's TSH gets too low, A-fib can result. Although this may not be your problem, it never hurts to have your PCP do a thyroid workup and at least eliminate that as a potential problem. God bless.

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I replied to a post on A fib and I don’t see it on here. Am I doing something wrong?

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Oh dear… It sounds like you need to be put in hospital and a total workup done on you. With a-fib that is not controlled you can be 'air hungry', needing to take big breaths in order to get enough oxygen. I don't know what meds and treatment you receive, but it sure sounds to me that your issues are not being addressed. In hospital, over a few days you can have various specialists see you and tests done, blood taken etc..all at once. Good luck!

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@carnes

I replied to a post on A fib and I don’t see it on here. Am I doing something wrong?

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Hi @carnes, I see your post here: https://connect.mayoclinic.org/discussion/afib-2/?pg=2#comment-365091 Is this the one you mean?
You can see all the posts you've made in your profile. Simply click on your @username to see your profile.

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I suffered through awful Afib until I finally had an ablation and a pacemaker at age 66. My cardiologist kept asking me to get a sleep study. But I had none of the symptoms of sleep apnea. Finally did what he asked me to do and had the study. Sure enough. Severe sleep apnea which according to my cardiologist was consistent with what he found when he did the ablation. Good thing to get that checked when you are trying to figure out your AFib problem. I feel great now and love my pacemaker and tolerate my Sleep Apnea machine! On Eloquis and that is all. Can drink coffee and wine etc……just do nothing to excess! Hope this helps!

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@colleenyoung

Hi @cadillac, welcome to Connect. You'll notice that I moved your message to this discussion about atrial fibrillation episodes in the Heart Rhythm Conditions group (https://connect.mayoclinic.org/group/heart-rhythm-conditions/). Here you'll find many people discussing aFib.

Cadillac, you ask about not being aware when you have an episode until you take your blood pressure and if there is a device you could wear to alert you. I'd like to bring others into the discussion to help answer your questions, like @jimana @predictable @sal70 @karenatmayo and @sandyabbey

Cadillac, are there times that you are aware of having an a-fib episode? How long have you been monitoring your blood pressure?

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The Apple Watch will monitor and alert you when you’re in a-fib. It would need to be Series 3 or 5.

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@lizzy102

The Apple Watch will monitor and alert you when you’re in a-fib. It would need to be Series 3 or 5.

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Needs to be a Series 4 or 5 Apple Watch (not a 3 for EKG). Also know the limitations-doesn’t check all the time for AFIb (& checks are test). Also check the settings for high & low heart rate…those only check when at rest & HR has to stay at/below the set levels for 10 minutes straight. Best is to run an EKG if things feel “off”. My BP monitor was showing irregular heart rates on multiple occasions on 3/10/19. Plus was getting very short of breath & couldn’t stay on my feet. Ran 9 EKGs & 7 came up AFIb. Only got 1 irregular heart rate warning from the Watch after I gave up for the day & decided to just stay in my recliner. Had appointment with my EP on 3/15 & showed him EKGs. Was put on meds for rhythm control & also Eliquis. Had ablation done on 7/29/19 & now feeling the best I have felt in years. Seeing him on 2/14/2020 & the plan is for a loop recorder to monitor so I can stop taking Eliquis.

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For all with A-Fib that is related to caffeine use, please note that a lot of cosmetic products, shampoos, etc. often have caffeine. I have a friend who avoided caffeine in her diet but if she had a little in a skin product it would set her off into an A-Fib episode. I did not know that these products have caffeine but some do so it's good to watch the labels.

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@lucy1002

Needs to be a Series 4 or 5 Apple Watch (not a 3 for EKG). Also know the limitations-doesn’t check all the time for AFIb (& checks are test). Also check the settings for high & low heart rate…those only check when at rest & HR has to stay at/below the set levels for 10 minutes straight. Best is to run an EKG if things feel “off”. My BP monitor was showing irregular heart rates on multiple occasions on 3/10/19. Plus was getting very short of breath & couldn’t stay on my feet. Ran 9 EKGs & 7 came up AFIb. Only got 1 irregular heart rate warning from the Watch after I gave up for the day & decided to just stay in my recliner. Had appointment with my EP on 3/15 & showed him EKGs. Was put on meds for rhythm control & also Eliquis. Had ablation done on 7/29/19 & now feeling the best I have felt in years. Seeing him on 2/14/2020 & the plan is for a loop recorder to monitor so I can stop taking Eliquis.

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@lucy1002 Good information, thank you!

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