Atrial Fibrillation (AFib) Support Group
Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). Heart beats in a normal heart begin after electricity generated in the atria by the sinoatrial node spread through the heart and cause contraction of the heart muscle and pumping of blood.
Hello. I have been reading your wonderful forum all day, and have learned so much. I just got out of the hospital after my first really bad afib episode.. and have so many questions.
I'm 54 and a former serious athlete. Looking back at my training diaries, I see so many entries when I was in my late teens, 20's and 30's saying "my heart is skipping beats." Over the years, I've been to cardiologists about my pre-mature beats, had echo cardiograms, and had been told, "Don't worry!"
I have had a history of tachycardia too, and was always told, "Don't worry!" About ten years ago, my heart was beating so fast, I went to the emergency room. By the time they put me on a monitor, everything was fine. I was told I had a "panic attack." No, I didn't. I don't have panic attacks. I kept being poo-pooed about my tachycardia and irregular heart beats.
Well, Tuesday night I showed them! :)
I was on a holter monitor because I had a scary cardiac event in the pool while swimming laps last October (I'll explain that another time) and FINALLY got in to see a heart rhythm specialist on Monday. My heart had been skipping around for two days, but Tuesday night, while lying in bed talking on the phone my heart rate stated climbing. Usually it goes down by itself, but this time, it went up and up. I called 911.
By the time they got to me, my heart was 190 bpm, and my bp was 190 over 110. They opened up a vein right in my living room and gave me cardizem. My heart converted an hour later in the emergency room. They admitted me... and now I'm on Bystolic (5mg) and one baby aspirin.
This all happened while I was on the holter monitor. I bet the electro-guy is going to have a field day looking at the results! (I see him this Tuesday).
I don't smoke, I exercise and eat organic. It makes me want to take up eating junk food, smoking cigars and drinking beer! This is what I get for being so health conscious??!!!! I will add, that my blood pressure has been all over the place... and it's been high lately. I was trying to get it down naturally.
Anyway.. I have lots of questions, but I don't want to load you with too much in my first post.
I'm very, very worried, depressed, and scared. I don't want to ever go through that again. Any words of advice, comfort, etc. would be most appreciated! Thanks for listening!
I'm 54 and a former serious athlete. Looking back at my training diaries, I see so many entries when I was in my late teens, 20's and 30's saying "my heart is skipping beats." Over the years, I've been to cardiologists about my pre-mature beats, had echo cardiograms, and had been told, "Don't worry!"
I have had a history of tachycardia too, and was always told, "Don't worry!" About ten years ago, my heart was beating so fast, I went to the emergency room. By the time they put me on a monitor, everything was fine. I was told I had a "panic attack." No, I didn't. I don't have panic attacks. I kept being poo-pooed about my tachycardia and irregular heart beats.
Well, Tuesday night I showed them! :)
I was on a holter monitor because I had a scary cardiac event in the pool while swimming laps last October (I'll explain that another time) and FINALLY got in to see a heart rhythm specialist on Monday. My heart had been skipping around for two days, but Tuesday night, while lying in bed talking on the phone my heart rate stated climbing. Usually it goes down by itself, but this time, it went up and up. I called 911.
By the time they got to me, my heart was 190 bpm, and my bp was 190 over 110. They opened up a vein right in my living room and gave me cardizem. My heart converted an hour later in the emergency room. They admitted me... and now I'm on Bystolic (5mg) and one baby aspirin.
This all happened while I was on the holter monitor. I bet the electro-guy is going to have a field day looking at the results! (I see him this Tuesday).
I don't smoke, I exercise and eat organic. It makes me want to take up eating junk food, smoking cigars and drinking beer! This is what I get for being so health conscious??!!!! I will add, that my blood pressure has been all over the place... and it's been high lately. I was trying to get it down naturally.
Anyway.. I have lots of questions, but I don't want to load you with too much in my first post.
I'm very, very worried, depressed, and scared. I don't want to ever go through that again. Any words of advice, comfort, etc. would be most appreciated! Thanks for listening!
Sorry to have to welcome you but if you are an afib sufferer you have certainly come to the right website. I get a lot of support from this panel. When the doctors first diagnosed afib I felt scared like you and was very ignorant of anything to do with the heart and have found important, informative, reassuring help from this gang, especially Pete.
Keep a positive attitude.
Moy...
Get any useful info at the EP today?
As I mentioned, I just happened to be wearing a holter monitor when I had my big afib event. He showed me the print out... oh my! You saw the bleep, bleep, bleep, and then huge spikes. It was scary to look at.
Turns out I was in afib for an hour before I converted...and I converted in the ambulance. He also said that I converted briefly, just for a few seconds a couple of times, but went right back into afib.
He said my heart converted itself. I told him the paramedics gave me cardizem, but he said that only slows down the rate, it doesn't convert your heart. That surprised me.
He likes that I'm on Bystolic... and says that's the first line of stabilizing my heart. I do have high blood pressure, so this will help in that department as well.
He said that in the stroke risk, I'm in the grey area between going on anti-coagulants and staying on aspirin. I'm on one baby aspirin a day.. he said to take two. My stroke risks are that 1) I have high blood pressure and 2) I'm female
He's going to put me on another monitor for three weeks straight to see how I'm doing on the bystolic. He wants to see if I'm having any premature beats.
If the bystolic fails, then I go on an antiarrhythmic. And, if that fails, the he said ablation. He doesn't think I'm anywhere near that point.
He thinks I will go into afib again, but how long is any one's guess. And, he said I can ease into exercise and let my body guide me.
I brought all my supplements, and he OK'd each one. Among others, they included folic acid, fish oil and vitamin d, an organic multi, vitamin e, a carnatine, and some others. He laughed and said that I would have expensive urine... but hey.. that's OK.. I'm going to try everything to get well.
I still don't understand how they can say afib doesn't kill. Yes it can.. had my heart not converted, I could have had heart failure.. or a heart attack. He said my pulse got up over 200. I thought it peaked at 190, but apparently it was higher. That's what makes this so frightening to me.
Anyway... next is the three week monitor, and then I see him in three months.
Wow, sounds like you got a lot of useful info from your EP. It sounded like he carefully evaluated your situation. You are right in that the high heart rate that sometimes comes with a fib is dangerous. Each time I was in the hospital, the main thing they were worried about was my high heart rate. They said it's like I was running a marathon for days. After awhile, your heart will just give out.
About cardizem, I was told that since it decreases your heart rate, your heart tends to convert back to normal sinus after receiving it. It didn't work that way on me. I stayed in a fib.
IT's good you don't have to face ablation for awhile. Hopefully your heart will settle down with the meds...
"Mitrani said one of the main jobs of electrophysiologists is to prevent sudden cardiac death.
When a patient dies suddenly it is often due to an irregular and fast heart beat in the ventricle called ventricular tachycardia or ventricular fibrillation. When the bottom chambers go excessively fast, then this is an immediately life threatening condition. In general, patients may need to be shocked to restore the rhythm to normal and save a life, he said."
Full story here:
http://www.local10.com/thats-life/health/Heart-rhythm-specialist-visits-Local-10/-/1717022/8761632/-/crt2y0/-/index.html
When you're newly diagnosed, it's a lot to take in. I think the hardest part is realizing that I'm not "bionic" anymore. I always thought that I would live to 100 because I've taken such good care of myself all these years.
And then.. I keep reading articles about middle aged women with afib "twice as likely to die"... etc. Very depressing.
I read these when I'm in a down mood:
Question: Can atrial fibrillation damage my heart in a permanent way, and can it cause a heart attack?
Answer : Atrial fibrillation can result in permanent heart damage, although that's fairly uncommon. The situation in which atrial fibrillation can cause permanent heart damage is if a patient develop atrial fibrillation and the heart rate ends up being very, very rapid for a long period of time.
So if someone develops atrial fibrillation, the upper chamber is going let's say 600 beats per minute. If the lower chamber is going more than a hundred beats a minute for weeks or months at a time, that can cause the lower chamber of the heart to wear out and you can develop congestive heart failure and you know, in rare circumstances that can cause you to have cardiac arrest and die.
Now the good news is, the type of heart failure that atrial fibrillation causes typically is reversible. And that if you slow the atrial fibrillation down, or get rid of it, the lower chamber of the heart commonly will recover either completely or almost completely.
In terms of a heart attack, a heart attack really is when the coronary artery occludes and you don't get enough blood supply to the heart and you damage or kill certain segments of the heart. And atrial fibrillation does not cause a heart attack per say. That's caused by blockages in the heart arteries.
Conclusions: Patients with asymptomatic AF have less serious heart disease but more cerebrovascular disease. Asymptomatic patients receive different therapies than symptomatic patients. However, the absence of symptoms and the differences in treatment does not confer a more favorable prognosis when differences in baseline clinical parameters are considered. Anticoagulation should be considered in these patients.
MLf: I have (or probably have) a chronic, mostly asymptomatic, AF, in which rate is controlled by means of meds (diltiazem & topranolol sp?), and rhythm problems are never symptomatic enough to be bothersome, is there any reason to consider anything more "invasive" than meds (eg any ablations?). I'm not keen on long-duration medication (at age 62, I take no other meds), but I presume that the lowest-risk treatment is most appropriate?
Dr__Lindsay: Two major studies have shown good outcomes in patients with asymptomatic atrial fibrillation provided that the rate is controlled well and the patients are appropriately anticoagulated. There is no proof that ablation procedures improve survival. The main indication for an ablation is to alleviate severe symptoms. A large multi-center clinical trial is in progress to compare long term outcomes in patients who are treated with medication compared with ablation procedures.
Beta-adrenergic blockers have been an option in the control of ventricular response in AF for many years; but recently, beta-blockers, along with calcium channel blockers, have replaced digoxin as first-line therapy for AF rate control. Randomized studies have confirmed the superiority of beta-blockers in controlling the ventricular response, especially with exercise.
Dr. Lindsay: Two clinical studies have shown that in patients who tolerate AF well, their life cycle is not shortened, nor do they have a higher incidence of heart failure or stroke. This assumes that some form of anticoagulation is in place.
Dr. Lindsay: No single medication is best for all patients. It is unlikely that the atrial fibrillation will determine how long you live. The aortic stenosis is far more important.
Widgeon: What percentage of people with afib have strokes?
Dr. Lindsay: The risk of stroke is in the range of 1% for those who are treated with anticoagulants and as high as 8-10% for those who are not. There is evidence that approximately 15% of strokes are caused by atrial fibrillation.
Motocat: Can ablation be safely done if taking pradaxa instead of coumadin?
Dr. Lindsay: Our policy is to stop the dabigatran the day prior to the ablation and resume it immediately after the ablation.
Motocat: Can you safely exercise with atrial fibrillation and resulting heart damage, how can you determine if the exercise you are doing is safe?
Dr. Lindsay: Patients can exercise with atrial fibrillation provided that their heart rate is controlled.
Dr. Van Wagoner: Stress is a risk factor for AF, perhaps due to increased sympathetic nerve activity. It sounds like stress reduction would be helpful, if challenging. If you are able to make time for exercise, this may help with sleeping and stress reduction. In a recent randomized clinical trial, short-term use of omega-3 pills did not help to prevent AF recurrence. As half of the recurrences occurred in the first two weeks of treatment, it is unclear if a benefit would have been detected with longer treatment. Omega-3 fatty acids can help to slow heart rate. If your resting heart rate is elevated, there may be a possible benefit.
The good news, he says, is that the risk of dying from atrial fibrillation is very low. In this study which took place over a 15-year period in women whose average age was in their early 50s, the death rate was less than one-half of one percent.
What is the take-home message? If there was one message I would want to take away from this particular study, it is that atrial fibrillation is benign and you can usually live a normal life. However, you need to be evaluated by a physician so you can get proper treatment and be assessed for associated risk factors.
Thus, there are 2 very important lessons to be learned. Patients with lone atrial fibrillation have a normal life expectancy, and they should be offered regular follow-up examinations to evaluate if and when they might be appropriate candidates for aspirin or oral anticoagulation according to current clinical guidelines.2
The excellent survival in patients with lone atrial fibrillation implies that any treatments associated with risk of serious adverse events such as long-term antiarrhythmic drug treatment or ablation should be offered only after a careful medical history is obtained and after the patient is informed about the superb prognosis without and any risk associated with such treatment.
If your AF heart rate is not excessive, its unlikely that you will develop heart failure. Likewise, if you have none of the 5 risks for stroke, or you take blood-thinning drugs, AF is unlikely to cause a stroke. In these cases, you dont have to take an AF-rhythm drug(s) or have an ablation. You can live with AF. You might not be as good as you were, but you will continue to be. All this is why AF treatment shouldnt be rushed.
Posted on 11/14/11, 08:11 am
http://circ.ahajournals.org/content/115/24/3040.full
http://www.stopafib.org/newsitem.cfm/NEWSID/347/Cleveland-Clinic-atrial-fibrillation-experts/afib-chat-transcript
http://my.clevelandclinic.org/heart/webchat/atrial_fibrillation_surgery_ablation.aspx