Paroxysmal Atrial Fibrillation and Ventricular Bigeminy

Posted by Z @zeiracorp, Aug 7 9:48pm

I've been complaining of periodic irregular heartbeat for years and my doctor's office could not capture it on any tests. I had a paramedic co-worker check my pulse one shift when I was having it and (of course a paramedic can't officially diagnose anything) he said, unofficially, it seemed to be a-fib. I felt that was correct. My doctor's office did EKGs, Stress Tests, and I wore a Holter Monitor, and it never occurred during these tests. It's been getting slowly but steadily worse this year lasting from a few minutes to a couple of days during which I get cold sweats and feel weak. I've had two episodes of steady, welling-up chest pain which subsided in 10 minutes or so, but were bad enough to make me consider a trip to the ER. When they subsided I did not go, because I'm well familiar with what would have happened- they would hook me up, run tests, find nothing and I'd get the $350 bill for going to the ER. So in a routing visit to my doctor's office I told them all this and they offered a new monitoring test called the Zio patch which I wore for 14 days. Not long after I applied the patch I had a very long (13 hours) episode of irregular heartbeat. It captured it and I got a diagnosis.

Paroxysmal Atrial Fibrillation and Ventricular Bigeminy are present. My doctor's office prescribed apixaban (Eliquis). I am very concerned about being permanently on blood thinners as no one I've ever known who was put on this type of drug ever lived very long (which doesn't mean the drug hastened their demise; it could simply be that anyone in that bad shape just might not be expected to live very long?).

Could anyone set my mind a little at ease on this prognosis?

@zeiracorp Hi and I would not get worried with just being on a blood thinner. I believe the diagnosis you mentioned is what most call afib with PVC. I did not have a fib myself but pvcs are pretty common even with a completely healthy person. But my first question is have you been seen by a cardiologist? Afib is usually managed by a special field within cardiology called an electrophysiological usually shortened to EP Cardiologist. They address the electrical portion of the heart. I personally had a similar problem with rapid heartbeat but it's in the lower chambers of the heart called Ventricular Tachycardia where with a fib it the upper chambers of the heart. The reason for the blood thinner is with afib there is a tendency for blood to pool in the heart which can cause a blood clot. But I have known a few people with a fib who leave a completely normal life for many years with no complications. So I would suggest seeking a cardiologist that specializes in that field and they can help figure out how to best address you particular situation. But really don't worry it's a real common diagnosis and is more common than you may realize. I hope that helps and please ask any questions you may have.
Have a Blessed Day
Dana

Liked by Z

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@danab

@zeiracorp Hi and I would not get worried with just being on a blood thinner. I believe the diagnosis you mentioned is what most call afib with PVC. I did not have a fib myself but pvcs are pretty common even with a completely healthy person. But my first question is have you been seen by a cardiologist? Afib is usually managed by a special field within cardiology called an electrophysiological usually shortened to EP Cardiologist. They address the electrical portion of the heart. I personally had a similar problem with rapid heartbeat but it's in the lower chambers of the heart called Ventricular Tachycardia where with a fib it the upper chambers of the heart. The reason for the blood thinner is with afib there is a tendency for blood to pool in the heart which can cause a blood clot. But I have known a few people with a fib who leave a completely normal life for many years with no complications. So I would suggest seeking a cardiologist that specializes in that field and they can help figure out how to best address you particular situation. But really don't worry it's a real common diagnosis and is more common than you may realize. I hope that helps and please ask any questions you may have.
Have a Blessed Day
Dana

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Thank you, Dana. I appreciate your response. They have already shipped my first Rx of apixaban.

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Blog thinners do not shorten lives

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@2880

Blog thinners do not shorten lives

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I didn't say they did. I said no one that I've personally known of who was in bad enough shape to be put on *blood* thinners ever lived very long. I am concerned because I expect I won't either. Not because of the blood thinners but because of the state of my condition. I suppose there are lots of people on blood thinners who do live fairly long. I just feel as if being put on blood thinners is a milestone (and not a good one), a harbinger of worse to come.

Now, "blog" thinners, well, that's another thing. My blog is already pretty thin. I think I'll avoid those. 🙂

Liked by Z

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When in a fib your blood pools in the heart and increasing chance of a stroke the blood thinners (help) to prevent that , there probably not much stronger than a baby aspirin. I’ve had afib for 7 years had ablation (age37) if I ever go into afib again blood thinner will be my first request

Liked by Z

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@tugboater

When in a fib your blood pools in the heart and increasing chance of a stroke the blood thinners (help) to prevent that , there probably not much stronger than a baby aspirin. I’ve had afib for 7 years had ablation (age37) if I ever go into afib again blood thinner will be my first request

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I'm actually aware of th blood pooling the increased risk being the reason for the meds, but thanks for sharing it, as it's of benefit for anyone reading. I really appreciate the reassurance. My a-fib is intermittent. What I've seen is that when I do have an episode of it, it seems worse than it used to, and lasts longer with more symptoms such as sweating and feeling a little faint (not good omens). I have an appointment with an orthopedic surgeon tomorrow morning, so I'm delaying starting the apixaban until after I talk to him. I've been putting off knee replacements (both) because I'm diabetic and worried about possible difficulty with healing from such a surgery. It's getting harder to walk, so I have to think about it. With the knee replacement surgery, I've seen encountered 4 people who have horror stories which worry me too. Nothing is without risk. Thanks again.

Liked by Z

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I started out with Ventricular Bigeminy which they also had issues catching on monitors although very symptomatic. It required a 14 day Irythm patch to catch that I had episodes up to 30 minutes long PVC after PVC. They attempted to ablate the PVC in June of 2020 and the mapping ablation was unsuccessful. Have they tried Flecanide for you if I had not been allergic it was very helpful the three weeks I took it? I developed Afib and Atrial Flutter recently picked up by my apple watch suggest you get one of those. Now I have been referred to Mayo because of the Bigeminy map issues. I would not worry about the blood thinners that doesn't cause issues it is the AFIB or the management of it that should be foremost in consideration. I have not really started my journey with it but my mom had 15 years of AFIB and a pacemaker for me to know what my path might look like.

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To "Z" When I was 68, I was also diagnosed with paroxysmal atrial fibrillation and ventricular bigeminy. My cardiologist started me on Xarelto immediately and we tried several types of antiarrhythmics, I tolerated the Xarelto well, but not so the antiarrhythmics. When the AFIB became intolerable to me, I was sent to an electrophysiologist and we discussed an ablation. (This whole process….. from my noticing the AFIB, consulting with my cardiologist, all the testing, and all the trials of antiarrhythmics took up the better part of a year) It was at the end of that year my cardio referred me to an electrophysiologist. During that year I remained on the Xarelto with no problems. In March of 2019, I underwent an ablation which was deemed a "success" at my 3 month follow up and again at my follow ups at 6 and 9 months. During that time I experienced a few PVC's which I put down to going one cup over my limit of coffee….and which my EP agreed with. In August of 2020, (1 year and 5 months POST my ablation) I had a very short run of AFIB, which scared me to death as I thought would have to undergo another ablation, which is NOT that uncommon. My EP put me on a ZIO patch for 2 weeks which showed 2 short runs of AFIB (that I was totally unaware of as I didn't push the button) and quit a few PVC's……….again, many of which I was unaware of. (I have had "palpitations/PVC's" since I was a teenager) I'm sure you've been told by now that EVERYBODY has PVC's…….it's just us "lucky ones" who feel them and are bothered by them. Anyway, when my EP was asking me what I had been doing just prior to this run of AFIB, I told him that I lived a pretty sedentary lifestyle, but THAT day was very sunny and hot and I had worked for hours in the yard. When he asked if had kept myself extremely well hydrated I had to confess (YOU NEVER LIE TO YOUR EP!) that I don't think I'd taken more than a few sips of water the entire day. After he got done yelling at me for my sedentary lifestyle, then suddenly deciding to work for hours in the hot sun and not bother to drink LOTS of fluids, he said he was 99% sure my AFIB episode was triggered by dehydration, which he said was a VERY common trigger for an AFIB episode. Since the episode only lasted a couple hours and my HR never exceeded 114 BPM, he said, for now, we'd just closely monitor it.(And no, he didn't really "YELL" at me……I just felt REALLY STUPID) Since then, I've had no AFIB episodes, at least that I'M aware of and have taken to drinking GALLONS of water if I so much as pull a few weeds! I have remained on the Xarelto with no side effects and have been told I will most likely be on a blood thinner the rest of my life, which I have also been completely reassured will NOT shorten my life but will, in fact, more than likely extend it. I also have two cardiac stents as I have hyperlipidemia…….this means my body produces far more cholesterol than it needs and the excess clogs my arteries. I also underwent surgery for an abdominal aortic aneurysm and had a stent placed. I am no stranger to the cath lab! But with my history, I'm staying on the Xarelto as the idea of a stroke really doesn't appeal to me. I'm sorry if this post was a bit confusing…..I DO tend to "wander off" while writing. I DID want to mention that I know (as a retired nurse) A LOT of people who have been on coumadin for YEARS AND YEARS. Yes, some of them died when they were well into their 90's. If you fear a blood thinner is going to shorten your life, I'd recommend you double check your source of information or talk with your cardio.

Liked by texas14

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@rubywitch67

To "Z" When I was 68, I was also diagnosed with paroxysmal atrial fibrillation and ventricular bigeminy. My cardiologist started me on Xarelto immediately and we tried several types of antiarrhythmics, I tolerated the Xarelto well, but not so the antiarrhythmics. When the AFIB became intolerable to me, I was sent to an electrophysiologist and we discussed an ablation. (This whole process….. from my noticing the AFIB, consulting with my cardiologist, all the testing, and all the trials of antiarrhythmics took up the better part of a year) It was at the end of that year my cardio referred me to an electrophysiologist. During that year I remained on the Xarelto with no problems. In March of 2019, I underwent an ablation which was deemed a "success" at my 3 month follow up and again at my follow ups at 6 and 9 months. During that time I experienced a few PVC's which I put down to going one cup over my limit of coffee….and which my EP agreed with. In August of 2020, (1 year and 5 months POST my ablation) I had a very short run of AFIB, which scared me to death as I thought would have to undergo another ablation, which is NOT that uncommon. My EP put me on a ZIO patch for 2 weeks which showed 2 short runs of AFIB (that I was totally unaware of as I didn't push the button) and quit a few PVC's……….again, many of which I was unaware of. (I have had "palpitations/PVC's" since I was a teenager) I'm sure you've been told by now that EVERYBODY has PVC's…….it's just us "lucky ones" who feel them and are bothered by them. Anyway, when my EP was asking me what I had been doing just prior to this run of AFIB, I told him that I lived a pretty sedentary lifestyle, but THAT day was very sunny and hot and I had worked for hours in the yard. When he asked if had kept myself extremely well hydrated I had to confess (YOU NEVER LIE TO YOUR EP!) that I don't think I'd taken more than a few sips of water the entire day. After he got done yelling at me for my sedentary lifestyle, then suddenly deciding to work for hours in the hot sun and not bother to drink LOTS of fluids, he said he was 99% sure my AFIB episode was triggered by dehydration, which he said was a VERY common trigger for an AFIB episode. Since the episode only lasted a couple hours and my HR never exceeded 114 BPM, he said, for now, we'd just closely monitor it.(And no, he didn't really "YELL" at me……I just felt REALLY STUPID) Since then, I've had no AFIB episodes, at least that I'M aware of and have taken to drinking GALLONS of water if I so much as pull a few weeds! I have remained on the Xarelto with no side effects and have been told I will most likely be on a blood thinner the rest of my life, which I have also been completely reassured will NOT shorten my life but will, in fact, more than likely extend it. I also have two cardiac stents as I have hyperlipidemia…….this means my body produces far more cholesterol than it needs and the excess clogs my arteries. I also underwent surgery for an abdominal aortic aneurysm and had a stent placed. I am no stranger to the cath lab! But with my history, I'm staying on the Xarelto as the idea of a stroke really doesn't appeal to me. I'm sorry if this post was a bit confusing…..I DO tend to "wander off" while writing. I DID want to mention that I know (as a retired nurse) A LOT of people who have been on coumadin for YEARS AND YEARS. Yes, some of them died when they were well into their 90's. If you fear a blood thinner is going to shorten your life, I'd recommend you double check your source of information or talk with your cardio.

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Excellent post On hydration , Ever since my afib ablation i now know when I’m dehydrated cause I will get lots of pvc . I drink lots of water and zero sugar Powerade .

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@rubywitch67

To "Z" When I was 68, I was also diagnosed with paroxysmal atrial fibrillation and ventricular bigeminy. My cardiologist started me on Xarelto immediately and we tried several types of antiarrhythmics, I tolerated the Xarelto well, but not so the antiarrhythmics. When the AFIB became intolerable to me, I was sent to an electrophysiologist and we discussed an ablation. (This whole process….. from my noticing the AFIB, consulting with my cardiologist, all the testing, and all the trials of antiarrhythmics took up the better part of a year) It was at the end of that year my cardio referred me to an electrophysiologist. During that year I remained on the Xarelto with no problems. In March of 2019, I underwent an ablation which was deemed a "success" at my 3 month follow up and again at my follow ups at 6 and 9 months. During that time I experienced a few PVC's which I put down to going one cup over my limit of coffee….and which my EP agreed with. In August of 2020, (1 year and 5 months POST my ablation) I had a very short run of AFIB, which scared me to death as I thought would have to undergo another ablation, which is NOT that uncommon. My EP put me on a ZIO patch for 2 weeks which showed 2 short runs of AFIB (that I was totally unaware of as I didn't push the button) and quit a few PVC's……….again, many of which I was unaware of. (I have had "palpitations/PVC's" since I was a teenager) I'm sure you've been told by now that EVERYBODY has PVC's…….it's just us "lucky ones" who feel them and are bothered by them. Anyway, when my EP was asking me what I had been doing just prior to this run of AFIB, I told him that I lived a pretty sedentary lifestyle, but THAT day was very sunny and hot and I had worked for hours in the yard. When he asked if had kept myself extremely well hydrated I had to confess (YOU NEVER LIE TO YOUR EP!) that I don't think I'd taken more than a few sips of water the entire day. After he got done yelling at me for my sedentary lifestyle, then suddenly deciding to work for hours in the hot sun and not bother to drink LOTS of fluids, he said he was 99% sure my AFIB episode was triggered by dehydration, which he said was a VERY common trigger for an AFIB episode. Since the episode only lasted a couple hours and my HR never exceeded 114 BPM, he said, for now, we'd just closely monitor it.(And no, he didn't really "YELL" at me……I just felt REALLY STUPID) Since then, I've had no AFIB episodes, at least that I'M aware of and have taken to drinking GALLONS of water if I so much as pull a few weeds! I have remained on the Xarelto with no side effects and have been told I will most likely be on a blood thinner the rest of my life, which I have also been completely reassured will NOT shorten my life but will, in fact, more than likely extend it. I also have two cardiac stents as I have hyperlipidemia…….this means my body produces far more cholesterol than it needs and the excess clogs my arteries. I also underwent surgery for an abdominal aortic aneurysm and had a stent placed. I am no stranger to the cath lab! But with my history, I'm staying on the Xarelto as the idea of a stroke really doesn't appeal to me. I'm sorry if this post was a bit confusing…..I DO tend to "wander off" while writing. I DID want to mention that I know (as a retired nurse) A LOT of people who have been on coumadin for YEARS AND YEARS. Yes, some of them died when they were well into their 90's. If you fear a blood thinner is going to shorten your life, I'd recommend you double check your source of information or talk with your cardio.

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Thank you for the post.
I never said I thought blood thinners would shorten my life. I said no one that I've personally known of who was in bad enough shape to be put on *blood* thinners ever lived very long. I am concerned because I expect I won't either. Not because of the blood thinners but because of the state of my condition. I suppose there are lots of people on blood thinners who do live fairly long. I just feel as if being put on blood thinners is a milestone (and not a good one), a harbinger of worse to come.
Well, eventually none of us is getting out of this alive so it's a moot point anyway. 🙂 (a little gallows humor never hurts)

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@rubywitch67

To "Z" When I was 68, I was also diagnosed with paroxysmal atrial fibrillation and ventricular bigeminy. My cardiologist started me on Xarelto immediately and we tried several types of antiarrhythmics, I tolerated the Xarelto well, but not so the antiarrhythmics. When the AFIB became intolerable to me, I was sent to an electrophysiologist and we discussed an ablation. (This whole process….. from my noticing the AFIB, consulting with my cardiologist, all the testing, and all the trials of antiarrhythmics took up the better part of a year) It was at the end of that year my cardio referred me to an electrophysiologist. During that year I remained on the Xarelto with no problems. In March of 2019, I underwent an ablation which was deemed a "success" at my 3 month follow up and again at my follow ups at 6 and 9 months. During that time I experienced a few PVC's which I put down to going one cup over my limit of coffee….and which my EP agreed with. In August of 2020, (1 year and 5 months POST my ablation) I had a very short run of AFIB, which scared me to death as I thought would have to undergo another ablation, which is NOT that uncommon. My EP put me on a ZIO patch for 2 weeks which showed 2 short runs of AFIB (that I was totally unaware of as I didn't push the button) and quit a few PVC's……….again, many of which I was unaware of. (I have had "palpitations/PVC's" since I was a teenager) I'm sure you've been told by now that EVERYBODY has PVC's…….it's just us "lucky ones" who feel them and are bothered by them. Anyway, when my EP was asking me what I had been doing just prior to this run of AFIB, I told him that I lived a pretty sedentary lifestyle, but THAT day was very sunny and hot and I had worked for hours in the yard. When he asked if had kept myself extremely well hydrated I had to confess (YOU NEVER LIE TO YOUR EP!) that I don't think I'd taken more than a few sips of water the entire day. After he got done yelling at me for my sedentary lifestyle, then suddenly deciding to work for hours in the hot sun and not bother to drink LOTS of fluids, he said he was 99% sure my AFIB episode was triggered by dehydration, which he said was a VERY common trigger for an AFIB episode. Since the episode only lasted a couple hours and my HR never exceeded 114 BPM, he said, for now, we'd just closely monitor it.(And no, he didn't really "YELL" at me……I just felt REALLY STUPID) Since then, I've had no AFIB episodes, at least that I'M aware of and have taken to drinking GALLONS of water if I so much as pull a few weeds! I have remained on the Xarelto with no side effects and have been told I will most likely be on a blood thinner the rest of my life, which I have also been completely reassured will NOT shorten my life but will, in fact, more than likely extend it. I also have two cardiac stents as I have hyperlipidemia…….this means my body produces far more cholesterol than it needs and the excess clogs my arteries. I also underwent surgery for an abdominal aortic aneurysm and had a stent placed. I am no stranger to the cath lab! But with my history, I'm staying on the Xarelto as the idea of a stroke really doesn't appeal to me. I'm sorry if this post was a bit confusing…..I DO tend to "wander off" while writing. I DID want to mention that I know (as a retired nurse) A LOT of people who have been on coumadin for YEARS AND YEARS. Yes, some of them died when they were well into their 90's. If you fear a blood thinner is going to shorten your life, I'd recommend you double check your source of information or talk with your cardio.

Jump to this post

Interesting about the dehydration being an aFib trigger. I think I will up my water drinking. I have been on warfarin 11 yrs and counting. Those of us that have had valve repair or replacement cannot take the DOAC’s. No studies were done on safety. I have testing kit for at home INR levels. So no trips to lab or Dr. I am not interested in a stroke either so take my blood thinner faithfully. I know many ppl who have taken them for decades w no side affects.

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@paula3166

I started out with Ventricular Bigeminy which they also had issues catching on monitors although very symptomatic. It required a 14 day Irythm patch to catch that I had episodes up to 30 minutes long PVC after PVC. They attempted to ablate the PVC in June of 2020 and the mapping ablation was unsuccessful. Have they tried Flecanide for you if I had not been allergic it was very helpful the three weeks I took it? I developed Afib and Atrial Flutter recently picked up by my apple watch suggest you get one of those. Now I have been referred to Mayo because of the Bigeminy map issues. I would not worry about the blood thinners that doesn't cause issues it is the AFIB or the management of it that should be foremost in consideration. I have not really started my journey with it but my mom had 15 years of AFIB and a pacemaker for me to know what my path might look like.

Jump to this post

Apple watch reminds me my cheapy equiv solution: free pulse rate app for cell phone. I use it each time I am concerned about one of my AFIB episodes – it CLEARLY shows each pulse, and captures the 120/sec and plots them across the phone screen. You can see them. ALL cell phones with a camera can run one of these many apps. They track the pulse rate so I can go back a month, year, and look at rates. All free. I think everyone with potential for AFIB should have one of these apps on their phone. Luckily I only use it about 1/week now when concerned and try to use it daily while walking uphill for excersize to see me reaching 115p/s or so…

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@texas14

Interesting about the dehydration being an aFib trigger. I think I will up my water drinking. I have been on warfarin 11 yrs and counting. Those of us that have had valve repair or replacement cannot take the DOAC’s. No studies were done on safety. I have testing kit for at home INR levels. So no trips to lab or Dr. I am not interested in a stroke either so take my blood thinner faithfully. I know many ppl who have taken them for decades w no side affects.

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"no side effects…" I know of 2 that affected me: 1) so expensive it can put one in the poor house (I did not say I preferred being planted 6ft under,, just listing a side affect), & 2) bruising/bleeding. I had a simple stick fling back when cutting firewood and hit my shin. No big deal. Except as I watched, it grew a bump that in an hour became the size of a baseball from the leaking blood under my skin. That is the day I stopped taking it (was on xarelto then switched to elequis due to cost). Then it took 3 weeks to go away! THIS side effect caused me to make
my cardiologist agree to me stop taking it. I am not very active, but I do cut 8 cords of wood a year, work in my woodworking shop, we raise and release wild animals for HS and bites happen. I thank z for this thread that brought up hydration! I learn something new every day!

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@yorlik

Apple watch reminds me my cheapy equiv solution: free pulse rate app for cell phone. I use it each time I am concerned about one of my AFIB episodes – it CLEARLY shows each pulse, and captures the 120/sec and plots them across the phone screen. You can see them. ALL cell phones with a camera can run one of these many apps. They track the pulse rate so I can go back a month, year, and look at rates. All free. I think everyone with potential for AFIB should have one of these apps on their phone. Luckily I only use it about 1/week now when concerned and try to use it daily while walking uphill for excersize to see me reaching 115p/s or so…

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By seeing each pulse you can clearly see if it is an AFIB or PVC.

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