Heart Rhythm Conditions – Welcome to the group

@robbarts Along with problems the aged have sleeping, our aged minds are surprisingly active often thinking of problems that we would like to solve. I find myself instantly active mentally as soon as I awaken to turn over or to free my arm or hand and get blood circulating again if I have sagged over it and put it 'to sleep.' But most of us manage to dream if we sleep for more than 100 minutes solid. The REM cycle happens roughly every 90 minutes or so, and sometimes the dream will raise cortisol levels, adrenalin, raise the heartbeat, raise the body's temperature...all cues that also happen, or were meant to, about 0600 when so many of us naturally awaken.

If you have a health app on your phone, and your wearable device is Bluetoothed to it, that app will tell you, in all likelihood, what the duration and quality of your sleep was the previous night. This is true for Apple and Android Galaxy watch wearers. There would be a graphic depiction of timeline with columns showing the stages of sleep and their total and relative percentages of the total time slept. If you have an SPO2 analytic, like my Galaxy watch has, it will be easy to correlate the times depicted when you were in REM sleep cycle and when your SPO2 and heart rate changed commensurately. In my case, my HR spikes when I am in REM, a surefire indicator that I am dreaming and something is making my sympathetic nervous system spike...including spiking adrenaline production. As you may already know, beta-adrenergic receptors are what sometimes trigger arrhythmias, and it is the drug like metoprolol that is meant to suppress that response if/when the heart commences to fibrillate.

So, AF can be triggered by adrenaline, and adrenaline is an sympathetic nervous system's response to whatever visualizations your sleeping brain conjures up.

But, there are other possible stimuli for AF. Acid reflux or GERD can set it off. Some people have the unfortunate habit of eating late, sometimes an hour or more before bed, but too soon. Before their stomachs have digested and begun to clear the contents, the person reposes and falls asleep. But, while they are relaxed, and prone or supine, or on their right side (duodenum facing downward), their pyloric valve has relaxed, or never closed completely, and it leaks acidic contents into the esophagus. You may not awaken, but your esophagus begins to scream. You can figure out the rest.

Hi. I discovered that I have nighttime afib episodes about a year ago. I have a fitbit watch that was alerting me to afib happening at night while I am asleep. It always happens at night when I'm sleeping and I am not aware of it. It only happens once a month and lasts a few hours. My cardiologist put me on a monitor which was able to record one of the episodes.
He then put me on Eliquis 5 milligrams twice a day. I've been on that for a year and have recently switched to 2.5 milligrams twice a day because of my age at 78 and the bleeding risk. Has anyone else had to do that?
I still am not sure what triggers it although I believe sometimes it's from anxiety or difficulty sleeping at night.

@martinzerr
Hello
I'm 76; former sufferer of Afib which lasted 10-12 hours, and led to passing out. Had a pacemaker, which I don't believe was the solution--the ablation was, that I had done at a local University Health center. I don't take any prescription drugs; got off Eliquis; and quit any alcohol, which is a main trigger for Afib. I use an iPhone with program to my Cardiologist, and iWatch to monitor my heart beat. Highly recommended.

@martinzerr Thanks

@chickenfarmer

@martinzerr I’ve tried Kardia mobile, Samsung Galaxy watch and Apple Iwatch. All 3 did well recording my heart beat traces. In most cases these devices are pretty accurate at diagnosing AF and Sinus rhythm . None are good at identifying PACs and PVCs, instead erroneously labeling these 30 sec traces as AFIB even though rate is low. However the traces are stored as PDFin smart phone and can show the quality of heart rhythm which you can share with EP. The Kardia sensor is separate; I carried it in my wallet but 2 of them stopped working within a few mos. I recommend using whichever watch that syncs with your current smartphone.

@nadanoel Depends on you and your EP.

How you feel. How awful. An EP can't fix an electrical disorder. They can control it...almost always, one way or another, including down to brass tacks....a pacemaker. If you are well and truly miserable when fibrillating, let them know. They do want to help........................but........

What else going on in you makes you a poor risk for an ablation? Any other severe limitations, comorbidities? Is your heart otherwise in good shape? If there are some structural problems, such as mitral valve prolapse or severe atherosclerosis? Chances are good he/she will want those taken care of first....if they can be fixed. In my case, it was sleep apnea, and he was very careful to test me on how well I was dealing with CPAP therapy. Even so, despite my enthusiastic and positive report on that account, he still wanted an MRI and an angiogram to rule out ischemia. Both had good results.

How much you have learned about your condition and what can be done. Tells them you are motivated to succeed.

But the EP, him/herself, has to be sufficiently skilled and experienced to KNOW they can take a good crack at breaking your fibrillation via catheter ablation. So, sometimes who that person is matters a great deal. If you're told no, ask another....one who deals routinely with complex cases.

@henry81 . My Original Question concerned whether my MICRA AV2 pacemaker is adequate current-status protection or treatment for my continuing AFIB. Certainly at the moment physicians see no problem -- I am the healthiest person in the room from the point of view of EPs and all the follow-up testing and monitoring But does the continuing AFIB suggest concern for continuing or future damage or need to additional precautions. e.g., progression to new addition all atrial rhythms? Other things equal, From clinical -historical viewpoint, other things equal, does the fact that I have well responding , asymptomatic AFIB with Pacemeker prolong my life beyond other EP steps that could be anticipated.

I'm a 73 yr old male on flecainide since 2021. Started with 100MG twice a day and had to go up to 150 at the end of 2022. My afib is well controlled with the flecainide, but I am interested in having an ablation and get off the flecainide. I have an appointment with my EP in a couple of months but I would like input about what smartwatch would be a good choice for health and sleep monitoring . Don't need the phone or fitness options, something accurate and not difficult to use.

@gloaming
Thank you for your prompt reply. Also, I was told that doing an ablation at my age was a fools errand. Has anybody had experience with the ablations after age 80?