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.
Some background:
Occasional palpitations over many years, not considered dangerous by cardiologist after wearing Holter monitor.
3 known episodes of Afib since April 2011, all detected by high heart rate (120's, 130's), all resolved by electrical cardioversion. 1 year interval between episode 1 and 2, 1 month between 2 and 3. Episodes likely caused by multi-hours stress periods the same day or the day before. On Metoprolol (25mg twice a day) and baby aspirin, anti-arrythmic drugs not suggested because of problems detected by echocardiogram.
EP was scary: he stated that the 3 episode trend indicated high likelihood of future frequent Afib, eventually permanent. I'll wear a Cardionet monitor (24x7 monitor) for 2 weeks, main objective is to detect if I have asymptomatic, normal heart rate Afib, or nocturnal undetected Afib.
I see 3 plans, depending on the Monitor results:
(1) NO asymptomatic-normal rate-Afib (or nocturnal undetected Afib) from Monitor readings. I am confident that I can detect high heart rate, hence Afib, pretty quickly. Plan is to stay on current Metoprolol & aspirin, no blood thinners as long as trips to ER caused by detection of high heart rate are rare.
(2) Asymptomatic-normal rate-Afib (or nocturnal undetected Afib) from Monitor readings. Start blood thinners. Consider ablation.
(3) Future trips to ER due to high heart rate become too frequent . Probably ablation. I am functioning decently when in Afib with high heart rate, but it seems that in the long term a high rate would damage the heart.
Some statements from EP:
Thinners reduce risk of stroke by 66%. Risk of bleeding with thinners much smaller than risk of stroke without thinners.
No existing solid study indicating that ablation is better than thinners in reducing risk of stroke. Some study in progress, that may indicate that ablation is better than thinners. Still an open issue.
This EP has done 500 ablations. Is this a good number?
My primary doc gave me a prescription of Escitalopram (10mg), an anti-depressant. Is anybody familiar with it?
Any comment would be welcome.
Your (scared) Ecofr
Occasional palpitations over many years, not considered dangerous by cardiologist after wearing Holter monitor.
3 known episodes of Afib since April 2011, all detected by high heart rate (120's, 130's), all resolved by electrical cardioversion. 1 year interval between episode 1 and 2, 1 month between 2 and 3. Episodes likely caused by multi-hours stress periods the same day or the day before. On Metoprolol (25mg twice a day) and baby aspirin, anti-arrythmic drugs not suggested because of problems detected by echocardiogram.
EP was scary: he stated that the 3 episode trend indicated high likelihood of future frequent Afib, eventually permanent. I'll wear a Cardionet monitor (24x7 monitor) for 2 weeks, main objective is to detect if I have asymptomatic, normal heart rate Afib, or nocturnal undetected Afib.
I see 3 plans, depending on the Monitor results:
(1) NO asymptomatic-normal rate-Afib (or nocturnal undetected Afib) from Monitor readings. I am confident that I can detect high heart rate, hence Afib, pretty quickly. Plan is to stay on current Metoprolol & aspirin, no blood thinners as long as trips to ER caused by detection of high heart rate are rare.
(2) Asymptomatic-normal rate-Afib (or nocturnal undetected Afib) from Monitor readings. Start blood thinners. Consider ablation.
(3) Future trips to ER due to high heart rate become too frequent . Probably ablation. I am functioning decently when in Afib with high heart rate, but it seems that in the long term a high rate would damage the heart.
Some statements from EP:
Thinners reduce risk of stroke by 66%. Risk of bleeding with thinners much smaller than risk of stroke without thinners.
No existing solid study indicating that ablation is better than thinners in reducing risk of stroke. Some study in progress, that may indicate that ablation is better than thinners. Still an open issue.
This EP has done 500 ablations. Is this a good number?
My primary doc gave me a prescription of Escitalopram (10mg), an anti-depressant. Is anybody familiar with it?
Any comment would be welcome.
Your (scared) Ecofr
Alot of excellent shared info/experience here on DS. Stopafib.org is also very, very good as well. I just don't get over there all too often and there's no exciting risque solicitation going on there as well.
What else can you share about your situation (physical condition, age, etc.)
All the best. - Thomas
There is no exact pattern to afib... it may progress at different rates... slowly or quickly.
It is a good idea at 70 to take an anticoagulant. That 66% number is the Coumadin (Warfarin) reduction in stroke number. As you get older and have other conditions (see CHA2DS2VaSC Score on Wiki), other newer anticoagulants can reduce stroke risk by 90%.
Your risk might range between 2-8% per year without anticoagulation, so you can run the numbers.
If you are asymptomatic, you don't have to go to ER.
500 ablations is a small number. You can find someone in your area that has done alot by going to the Heart Rhythm Society website and click on "Find a Specialist". But you shouldn't be rushing into an ablation... btw they usually give you rhythm drugs along with the ablation.
Address your other medical issues. Take an anticoagulant. If rate control is necessary, take it.
Afib won't kill you. Strokes will.
Research this site. Much good info. Don't let my picture scare you off. Alot of people think I look like Don Knotts. I think I look more like Harrison Ford. Do you agree? :-) petey
I don't plan to rush in an ablation. But even with anticoagulants I would not like to have continuously a high heart rate, even if it gives me minor symptoms. My Afib episodes were all tied to a high rate. You have continuous afib treated with anticoagulants, what's your heart rate?
Would you still suggest anticoagulants if my afib stays rare, quickly detected by high heart rate, and promptly stopped at ER ?
You're a nice guy, I'll say Harrison Ford.
my doc's card says electrophysiology does that mean he is ep he was eager for me to go for aablation which i politely refused,
he wants to do a cardioversion on me since i never had one before .
i am on warafin and the other drugs which you know of .such as toporol and digoxin .
in any case what he said he has done 80 ablations and from what i see that number is nothing .
just wanted to share this
ray
ecofr: Good well thought out (OCD sounding) plan. You sound like me with the "what if" logic tree. The drug is a typical SSRI ... is it for anxiety and obsessive thoughts?
No rush on ablation... see the results... go to a more experienced EP. You have time to slip out from under this doctor.
petey
Don who?
Now if it was Brad Pitt, I might say something.
Best to keep our real mugshots up and running for all to solicit. Especially all of the Drama Queens out there (you know who you are). ;)
Excellent advice Petey and it doesn't surprise me what the EP said about frequent recurring episodes after 3 - given your (Ecofr's) age.
Things can change after 50 and change even more down the road, That's just the way it is.
I think the one trick AFers out there are much younger and might fall into some sport related exercise activity or the often used "Holiday Heart Syndrome" gig.
I sincerely hope the best for all of us regardless of age with this AF gig, as twisted and complicated as it is. - Thomas
I am on dititzem 120 ER, warfin and when I feel a prolonged heart flutter or raised heart rate I take one pill, 12.1/2 of a beta blocker and that has stopped the beast so far. My Doc also says the afib will get worse as I get older.
I am also on Lexapro and it works great for my depression
thanks for the info. What are your triggers? How do you detect your Afib episodes?
It's encouraging that you've been event free for a year.
What beta blocker and dosage you take when you feel flutter or raised heart rate?
thanks again.
At the time I was taking BP, statin and Vit D meds. My cardiologist convinced me I should be on a blood thinner. I refused other possible AF medications. I'm on Warfarin with no ill effects or inconvenience + the Vit D3. Currently I'm no longer on the BP pills and coming off the statin. 95% of the time paying attention to my triggers I'm in NSR. AF arrives for me at night and often will last through the next day.
My triggers are alcohol, eating before retiring, and maybe anxiety before airline flights. I am aware of when my irregular HB begins and ends, Aside from that I've been relatively symptom free.
My AF has improved. I'm able for the most part to carry on with my regular activities. I chance a drink now and then but not if I have volunteering or other important activities planned the next day.
I "feel" I'm in control? Just booked a July 12th 10 day RT SF/Alaskan cruise.
I've learned so much from this great group in these discussions.
It is a "Family of Friends". Wishing everyone NSR.
Annette
When I go into afib my heart rate jumps up to 150 or 180 then bounces back down. It has lasted for 12 hours when I first had it.
I was chemically converted one time and found out it was afib.
Now when I feel my heart acting the least bit funny I take a 12 1/2 mg beta blocker.
Sometimes if I can go for a brisk walk and it puts me back into NSR.
However eveyone is different, so please read this site and see how others cope and ask your Dr. many questions.
Good luck, Dee