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.

@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

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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.

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….

Liked by Soliloquized

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.

@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…

@ilnapenny

I sincerely thank you…

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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…

Liked by Soliloquized

@ilnapenny

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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I'm sorry to hear of your health issues, though mine aren't identical, they are extensive. 15 years having seizures that went undiagnosed, they weren't Grand Mal. Years of visual migraines likely related to the seizures, but never proven. I've gone blind in one eye for less than 15 minutes twice over 15 years, nearly blind several times, experienced periodic episodes of double vision, one almost resulting in loss of consciousness, and believed to be Basilar Migraine. I've had bouts of PVCs, premature ventricular contractions, and one doctor wanted to ablate an episode that was particularly persistent but there was no emergency reason to do it, so I waited and they subsided. And I developed Chronic Urticaria, aka Hives, that lasted almost 2 years. To top it off, last November, I went into Afib, and am still in it today.

So, I understand, but the doctor's have no real answers for me either.

I'm curious about your heart rate, is it caused by the Afib/Atrial Flutter or not? The heartbeat originates at on the top of the heart, travels to the junction between the top and bottom known as the AV (Atrio Ventricular) Node. This node ordinarily keeps the very fast Atrial Signals from being conveyed to the bottom of the heart, at least not at the extremely fast rate of the atria.

If I'm not mistaken, sometimes a Pacemaker is used in the case of Afib, but I think they ablate the AV Node so that no activity from the top of the heart can reach the bottom. It makes the person Pacemaker Dependent for the rest of their life, but it should stop the fast Ventricular Rate.

Why were you given a Pacemaker? Are you currently considered to have Congestive Heart Failure, if so, my wife thinks that's contributing to the pneumonia?

@soliloquized

I'm sorry to hear of your health issues, though mine aren't identical, they are extensive. 15 years having seizures that went undiagnosed, they weren't Grand Mal. Years of visual migraines likely related to the seizures, but never proven. I've gone blind in one eye for less than 15 minutes twice over 15 years, nearly blind several times, experienced periodic episodes of double vision, one almost resulting in loss of consciousness, and believed to be Basilar Migraine. I've had bouts of PVCs, premature ventricular contractions, and one doctor wanted to ablate an episode that was particularly persistent but there was no emergency reason to do it, so I waited and they subsided. And I developed Chronic Urticaria, aka Hives, that lasted almost 2 years. To top it off, last November, I went into Afib, and am still in it today.

So, I understand, but the doctor's have no real answers for me either.

I'm curious about your heart rate, is it caused by the Afib/Atrial Flutter or not? The heartbeat originates at on the top of the heart, travels to the junction between the top and bottom known as the AV (Atrio Ventricular) Node. This node ordinarily keeps the very fast Atrial Signals from being conveyed to the bottom of the heart, at least not at the extremely fast rate of the atria.

If I'm not mistaken, sometimes a Pacemaker is used in the case of Afib, but I think they ablate the AV Node so that no activity from the top of the heart can reach the bottom. It makes the person Pacemaker Dependent for the rest of their life, but it should stop the fast Ventricular Rate.

Why were you given a Pacemaker? Are you currently considered to have Congestive Heart Failure, if so, my wife thinks that's contributing to the pneumonia?

Jump to this post

GoodMorning to you hoping all is well. So sorry to hear about your health issues.. its absolutely crazy to not be well, we know something is wrong, but we cannot get a proper diagnosis. Its so frustrating. Yes I was diagnosed with congestive heart failure which caused DVT so am on Xarelto blood thinner. I go back and forth between Afib and Aflutter. my heart rate was 180/260 last September 2018 so I am now on Rythmol (Propeferone – 225mg) to control that. I was told by Docs that my heart is totally dependent on the pacemaker and will be for life. it was installed because of the rapid heart beats.. I recently had 2 unsuccessful ablations last year so am like what now….. you know. May I ask why your wife thinks that Heart Failure is contributing to the pneumonia?? i had pneumonia in Nov 2018 jan and mar 2019. The pulmonologist seems baffled and dont know why it keeps coming back. I have had 2 CT scans 3 chest xrays ( no definitive answers there either) and a upper GI series test that checks the stomach for ulcers and what not. am still waiting for results of those.. I do hope you get some answers from the Docs on why you are going thru those changes with your heart rate. Hope to hear back from you and thank you for responding..

Liked by Soliloquized

@ilnapenny

GoodMorning to you hoping all is well. So sorry to hear about your health issues.. its absolutely crazy to not be well, we know something is wrong, but we cannot get a proper diagnosis. Its so frustrating. Yes I was diagnosed with congestive heart failure which caused DVT so am on Xarelto blood thinner. I go back and forth between Afib and Aflutter. my heart rate was 180/260 last September 2018 so I am now on Rythmol (Propeferone – 225mg) to control that. I was told by Docs that my heart is totally dependent on the pacemaker and will be for life. it was installed because of the rapid heart beats.. I recently had 2 unsuccessful ablations last year so am like what now….. you know. May I ask why your wife thinks that Heart Failure is contributing to the pneumonia?? i had pneumonia in Nov 2018 jan and mar 2019. The pulmonologist seems baffled and dont know why it keeps coming back. I have had 2 CT scans 3 chest xrays ( no definitive answers there either) and a upper GI series test that checks the stomach for ulcers and what not. am still waiting for results of those.. I do hope you get some answers from the Docs on why you are going thru those changes with your heart rate. Hope to hear back from you and thank you for responding..

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Hi, Thanks for writing back.

1. "Pulmonary edema is often caused by congestive heart failure. When the heart is not able to pump efficiently, blood can back up into the veins that take blood through the lungs." If Edema occurs, the natural functions of the lung are impaired. Myself, since I was diagnosed with Chronic Urticaria (Hives) I was put on Singulair. As a result, my breathing has been much more normal now, and the rate of contracting colds seems to be at an adult (for me) all time low. Prior to taking Singulair, I was using a Steroid Inhaler, it just didn't work as well as Singulair does for me. If your lungs are compromised, it may be contributing to infections that are the prelude to pneumonia.

2. You may be regarded as Pacemaker Dependent, but ask your doctor for more specifics. The heart beat originates in the SA Node on the top of the heart, travels a pathway to the AV Node between the top and bottom of your heart, and then down to the bottom. Some patients with a Pacemaker have AV Node Ablation, preventing the erratic signals from your AFib from reaching the bottom of your heart. I'm no doctor, but I've read that once the patient is provided with a Pacemaker, and at some point the AV Node is ablated, that Atrial Fibrillation ceases to be a problem for your heart rate, it can't reach the Ventricles.

Is your fast heart rate due to Afib? What are they trying to ablate? The Pulmonary Veins that return oxygenated blood to the Left Atrium are a common source of Afib, there's 4 veins, and they have the unique distinction of being the only veins (vs Arteries) that carry Oxygenated Blood.

Look forward to hearing more.

@soliloquized

Hi, Thanks for writing back.

1. "Pulmonary edema is often caused by congestive heart failure. When the heart is not able to pump efficiently, blood can back up into the veins that take blood through the lungs." If Edema occurs, the natural functions of the lung are impaired. Myself, since I was diagnosed with Chronic Urticaria (Hives) I was put on Singulair. As a result, my breathing has been much more normal now, and the rate of contracting colds seems to be at an adult (for me) all time low. Prior to taking Singulair, I was using a Steroid Inhaler, it just didn't work as well as Singulair does for me. If your lungs are compromised, it may be contributing to infections that are the prelude to pneumonia.

2. You may be regarded as Pacemaker Dependent, but ask your doctor for more specifics. The heart beat originates in the SA Node on the top of the heart, travels a pathway to the AV Node between the top and bottom of your heart, and then down to the bottom. Some patients with a Pacemaker have AV Node Ablation, preventing the erratic signals from your AFib from reaching the bottom of your heart. I'm no doctor, but I've read that once the patient is provided with a Pacemaker, and at some point the AV Node is ablated, that Atrial Fibrillation ceases to be a problem for your heart rate, it can't reach the Ventricles.

Is your fast heart rate due to Afib? What are they trying to ablate? The Pulmonary Veins that return oxygenated blood to the Left Atrium are a common source of Afib, there's 4 veins, and they have the unique distinction of being the only veins (vs Arteries) that carry Oxygenated Blood.

Look forward to hearing more.

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GoodMorning @soliloquized am just now seeing your response (so sorry). The responses were going to my spam email and I was deleting the spam not knowing. Now that made me sad because I didnt get to read all the responses from my original post. My fast heartrate is due to Afib. They ablated back in Jun 2018 but it was unsuccessful. My heartrate jumps to 130 to 160 bpm so they have been upping my rythmol which is crazy it has my body feeling outright exhaused. I recently was told am having PAC in the upper chamber which is what may be causing my palpitations. Its a horrific feeling all off in my neck and only so at night. I think EP and cardiologist is thinking of ablating again but my body is so tired. They are trying to look into other options i was told by the nurse. Am not sure now what they are trying to ablate but I now will certainly ask. I am having these palpitations and night sweats often. Am so scared the heart will get tired and stop. Am just not sure what else to do or ask. Thank you so much for your response. Hope you are doing well…

Liked by Soliloquized

@soliloquized

Hi, Thanks for writing back.

1. "Pulmonary edema is often caused by congestive heart failure. When the heart is not able to pump efficiently, blood can back up into the veins that take blood through the lungs." If Edema occurs, the natural functions of the lung are impaired. Myself, since I was diagnosed with Chronic Urticaria (Hives) I was put on Singulair. As a result, my breathing has been much more normal now, and the rate of contracting colds seems to be at an adult (for me) all time low. Prior to taking Singulair, I was using a Steroid Inhaler, it just didn't work as well as Singulair does for me. If your lungs are compromised, it may be contributing to infections that are the prelude to pneumonia.

2. You may be regarded as Pacemaker Dependent, but ask your doctor for more specifics. The heart beat originates in the SA Node on the top of the heart, travels a pathway to the AV Node between the top and bottom of your heart, and then down to the bottom. Some patients with a Pacemaker have AV Node Ablation, preventing the erratic signals from your AFib from reaching the bottom of your heart. I'm no doctor, but I've read that once the patient is provided with a Pacemaker, and at some point the AV Node is ablated, that Atrial Fibrillation ceases to be a problem for your heart rate, it can't reach the Ventricles.

Is your fast heart rate due to Afib? What are they trying to ablate? The Pulmonary Veins that return oxygenated blood to the Left Atrium are a common source of Afib, there's 4 veins, and they have the unique distinction of being the only veins (vs Arteries) that carry Oxygenated Blood.

Look forward to hearing more.

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@soliloquized, I can send you my email in private message if you’d like. I’m hoping it comes to my inbox instead of the spam box. have a good day….

Liked by Soliloquized

@ilnapenny

GoodMorning @soliloquized am just now seeing your response (so sorry). The responses were going to my spam email and I was deleting the spam not knowing. Now that made me sad because I didnt get to read all the responses from my original post. My fast heartrate is due to Afib. They ablated back in Jun 2018 but it was unsuccessful. My heartrate jumps to 130 to 160 bpm so they have been upping my rythmol which is crazy it has my body feeling outright exhaused. I recently was told am having PAC in the upper chamber which is what may be causing my palpitations. Its a horrific feeling all off in my neck and only so at night. I think EP and cardiologist is thinking of ablating again but my body is so tired. They are trying to look into other options i was told by the nurse. Am not sure now what they are trying to ablate but I now will certainly ask. I am having these palpitations and night sweats often. Am so scared the heart will get tired and stop. Am just not sure what else to do or ask. Thank you so much for your response. Hope you are doing well…

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My mother lived into her 90s, much earlier, my wife and I were called to the hospital, they felt she would soon pass away (she didn't) and we noticed she was wearing a DNR Wristlet (Do Not Resuscitate). I asked her if she knew what it meant, she did.

Despite the Wristlet, later that night, they gave her a Pacemaker. She instantly turned around, she was a different person. She had a Pacemaker with a Defibrillator, and it fired once when it shouldn't have. Apparently her afib had influenced the bottom of the heart so much that the Defibrillator thought it was needed. To prevent this, they Ablated the AV Node, there was then no way for the Atrial Fibrillation to influence the Ventricles. At that point she was Pacemaker Dependent.

She lived for 5 or more years after that, healthy as can be expected (she had other issues), and she passed away from something unrelated to the heart and pacemaker.

It was my understanding that for Afib that doesn't respond to medication, and ablation, that pacemakers are used and the AV Node is ablated, that way the ventricles no longer respond to the rapid chaotic rates of the Atrium. Ask your doctor about your AV Node, is in intact or has it been ablated. Rarely, there's another way Atrial Signals make it to the Ventricles, I believe they're called Accessory Pathways, they'd have to be ablated too, but they're not common.

@ilnapenny

@soliloquized, I can send you my email in private message if you’d like. I’m hoping it comes to my inbox instead of the spam box. have a good day….

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Hi @ilnapenny,

I’m so glad to see that you’ve chosen to be an active, participating member of the Connect community – thank you for all the support and information you are offering. You may notice that I removed your personal email and address from this public discussion – we recommend not sharing personal contact information in a public online forum because we don't want you to get unwanted spam as a result. Instead we recommend using the private message functionality.
I would also like to mention that the value in an online community are the public group discussions because they not only help the people actively participating in them, but also the people reading them and learning from them.

Thanks for understanding.

Liked by Soliloquized

@kanaazpereira

Hi @ilnapenny,

I’m so glad to see that you’ve chosen to be an active, participating member of the Connect community – thank you for all the support and information you are offering. You may notice that I removed your personal email and address from this public discussion – we recommend not sharing personal contact information in a public online forum because we don't want you to get unwanted spam as a result. Instead we recommend using the private message functionality.
I would also like to mention that the value in an online community are the public group discussions because they not only help the people actively participating in them, but also the people reading them and learning from them.

Thanks for understanding.

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I anticipated your noticing and I saved the email address separate from the post, i.e. copy and pasted. Yet I understand why such actions are necessary, and fully agree with the stated reasoning. Private Messenging is a nice feature, I'll have to try it, and open discussions are imperative to assuring that anything intentionally or inadvertently incorrect can be addressed by others.

I trust that implicit in your message is that people can exchange email addresses via Private Messaging.

@kanaazpereira

Hi @ilnapenny,

I’m so glad to see that you’ve chosen to be an active, participating member of the Connect community – thank you for all the support and information you are offering. You may notice that I removed your personal email and address from this public discussion – we recommend not sharing personal contact information in a public online forum because we don't want you to get unwanted spam as a result. Instead we recommend using the private message functionality.
I would also like to mention that the value in an online community are the public group discussions because they not only help the people actively participating in them, but also the people reading them and learning from them.

Thanks for understanding.

Jump to this post

Hello and Thank you for explaining that, I absolutely would prefer an open forum indeed. We can learn so much more. Unfortunately I just realized the responses from my previous questions were going to my spam mail and I deleted them all by accident. Therefore I thought if I post my email it would go to my inbox directly as oppose to spam box. But I certainly understand it being removed. I will be careful not to delete my spam mail before going through them. Thank again…..

Liked by Soliloquized

@soliloquized

My mother lived into her 90s, much earlier, my wife and I were called to the hospital, they felt she would soon pass away (she didn't) and we noticed she was wearing a DNR Wristlet (Do Not Resuscitate). I asked her if she knew what it meant, she did.

Despite the Wristlet, later that night, they gave her a Pacemaker. She instantly turned around, she was a different person. She had a Pacemaker with a Defibrillator, and it fired once when it shouldn't have. Apparently her afib had influenced the bottom of the heart so much that the Defibrillator thought it was needed. To prevent this, they Ablated the AV Node, there was then no way for the Atrial Fibrillation to influence the Ventricles. At that point she was Pacemaker Dependent.

She lived for 5 or more years after that, healthy as can be expected (she had other issues), and she passed away from something unrelated to the heart and pacemaker.

It was my understanding that for Afib that doesn't respond to medication, and ablation, that pacemakers are used and the AV Node is ablated, that way the ventricles no longer respond to the rapid chaotic rates of the Atrium. Ask your doctor about your AV Node, is in intact or has it been ablated. Rarely, there's another way Atrial Signals make it to the Ventricles, I believe they're called Accessory Pathways, they'd have to be ablated too, but they're not common.

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So glad to hear/know that it its indeed possible to live a long life with Heart Failure… Its such a roller coaster ride. I will certainly ask my EP about my AV Node if its intact. I see them in 2 weeks. Thats when I will find out if they will do another ablation or whats d next step. I am so afraid. It makes me anxious and I think that triggers the palpitations.

Liked by Soliloquized

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