AT/AF

Hello, and welcome to the Mayo Clinic community. Some of us are highly symptomatic when it comes to heart arrhythmias and some are not. I am almost consumed by my AF when it happens because I can feel it. Some have no idea. The same for flutter. They are lucky, but only in that respect; they also are late to be detected and when it happens they may be too late to have a meaningful intervention. That is but one reason that annual exams are important. You do not want to be in arrhythmia long because the heart will change itself, called 'remodeling', and not in a good way. You want your arrythmia controlled or stopped...ideally.

You are on apixaban, the drug marketed as 'Eliquis'. The reason you are on it is because the single great immediate risk with AF is stroke. The reason is that the poorly circulating blood in the left atrium might go stale, especially in the 'left atrial appendage', a small grotto on the extremity of the atrium. Later on, left uncontrolled, AF will cause enlargement of the left atrium, fibrosis, possibly mitral valve prolapse, and this makes treating it very tough indeed. So you want it controlled, and you want a direct oral anti-coagulant, which is what you are taking. Good. The control is via an anti-arrhythmic drug, if one can be used effectively for your circumstances, or via metoprolol or diltiazem, as examples, of beta blockers or calcium channel blockers. In severe instances, an potassium channel blocker called amiodarone is used, but that is literally a drug of last resort. ( I actually googled that very question and got a 'yup' out of my search.)

Your best approach is to be referred soon to an electrophysiologist, cardiac electrical experts, who are trained to treat such problems. Hopefully you have a couple of really good ones within a few hours drive who can help you with that.

Thank you for your response. I will be seeing my cardiologist next month and I will ask her about seeing an EP

Hello, the last five years i have been taking xarelto 20mg for a A-Fib and i had no problems, i was feeling well, but lately i can feel my heart beat again during the day, i hope i can get an answer maybe has the same problem as me, i appreciate an answer, ty so much

Hello to you, and welcome. AF is, most unfortunately, a progressive disorder of the heart. It evolves over time. For some, the evolution is rapid, while for some it can take a decade or even two before more serious methods must be undertaken to keep it controlled. You seem to be like me; I was good on drugs for three years, and then the wheels got wobbly and began to fall off, one-by-one.

You are experiencing 'palpitations' which is the medical term for what the patient feels when his/her heart is misbehaving. It's not a diagnosis...it's a symptom. Just as a doctor cannot diagnose 'headache', because it's the patient that tells her what she has, the physician will look for a cause, and THAT is the diagnosis. In your case, you have what are very likely palpitations from a repeat of AF. Unless you have a way to determine for yourself that you have AF, you'll need a doctor or a nurse to feel your wrist, or you'll need an ECG (electrocardiogram) hooked up, 12 leads usually, and a 15 second reading taken when you feel the palpitations...which are coming and going.

That your palpitations are there, and then gone again, is a good sign. It means you're still in the 'paroxysmal' stage, the one where it's easiest to treat you. If you ignore the arrhythmia, your heart will continue to progress toward more advanced, and more difficult to treat, levels of AF. So you want to let your doctor know what is happening, and you want to be placed in the pipeline to see an electrophysiologist, hopefully a really good one locally. Note that their experience and skills vary between EPs, and you want the most skilled, the most experienced, the busiest, and the most successful EP there is. He/she will claim a success rate for first albations, which is what we're talking about procedurally, of at least 75% Ablation of the left atrium is what we're talking about, literally causing a circular, or coffer, dam of scar tissue, around the pulmonary veins where they empty their oxygenated pulmonary blood returned to the heart.

To keep this short, you'll have to ask a cardiologist about the changes, and hopefully get referred to an electrophysiologist, and EP, sooner rather than later when your heart is more advanced in its progression toward persistent, and then permanent AF.

I thank you so much for your answer, i will call monday my cardiologist and i will ask for an electrophysiologist and EP, i will keep in touch and let you know, thank you again, i really appreciate your answer.

What you are feeling may not be Afib. Feeling you heart beat could be a number of issues including PACs, PVCs and even spikes in blood pressure, anxiety and electrolyte imbalance can cause those sensations. So you need more info than can be answered by anyone here. A trip to an Electrophysiologist would be the best place to start. Their specialty is electrical problems that cause the feeling you are experiencing.

Hello, i really appreciate your response, i wa s looking into PACs and PVCs i did not know the meaning, now i know and it's scary, i really hope it's not that serious, i do have high blood pressure, i will call my cardiologist tomorrow, will see what he says, i thank you so much, i will keep in touch, thank you again

Everyone has PACs. Everyone. Some more than others. Electrophysiologists won't treat PACs normally, and they encourage you to endure them. Find a distraction. However, the literature says that a burden much higher than about 3% is associated with a marked rise in morbidity. If they continue to increase in frequency, and are so disruptive of your quality of life that you begin to slip, then they'll map you and figure out how to rid you of them with an ablation. It's nothing remotely as straightforward as isolating the pulmonary veins.