How do I know I’m in Afib ? - Atrial Fibrillati...

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How do I know I’m in Afib ?

Puzzled8 profile image
35 Replies

Diagnosed with afib about 6 weeks ago. Was being treated for tachycardia prior to this, with Diltiazem 120mg x 2d. . Now on 180mg Diltiazem x 2 day, plus Edoxaban. I wasn’t aware of myself being “ in afib” until I was seen by gp. I’ve read lots of comments here where people seem to know when they go into afib. Can I ask how you know ? What should I be looking out for? I’m so used to getting breathless and tired due to tachycardia, ischaemic heart disease, angina, and bronchiectasis. Still waiting on cardiology appts. so haven’t been able to ask consultant these things yet. Thanks for any advice.

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Puzzled8
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mav7 profile image
mav7

You always will not know if you are in afib, especially considering your other issues.

If the GP has not, ask to wear a holter monitor or other medical device for an extended period to determine the exact frequency of your afib. The cardiology appts will discuss this but would be good if the GP can order prior.

If you desire, consider investing in an Apple Watch, Kardia device, or other device to monitor your heart rate and provide an EKG Also monitor your blood pressure.

Relax and enjoy the journey. You are among friends. :)

Puzzled8 profile image
Puzzled8 in reply tomav7

Thank you Mav7. Yes it really does feel as though I’m among friends. Replies have been really helpful. Don’t think there’s much chance of my gp doing anything prior to seeing cardiologist. I am currently considering the Kardia and/or Apple Watch. I think I’m now over the shock of the diagnosis and feel more reassured now.

pottypete1 profile image
pottypete1

For me it has always been as simple as feeling awful and my body a bit like an old car firing on 3 cylinders.

I would then just feel my pulse just to check and it was easy to detect the erratic rhythm of my heart beating.

Pete

Puzzled8 profile image
Puzzled8 in reply topottypete1

Thanks Pete. Yes I understand those periods of feeling awful. For someone who has always liked to be busy, it can take a bit of getting used to. I now need to pace myself and have to sit and rest regularly. Not too good at taking my pulse yet but will keep practicing.

pottypete1 profile image
pottypete1 in reply toPuzzled8

Place 3 finger tips of your left hand gently on the RH side of your wrist.

Pete

mjames1 profile image
mjames1

The only way you can conclusively know is by ekg. That's because different types of tachycardia's can present with the same symptoms plus afib can also present at a lower rate. Many of us here have an Apple Watch or Kardia device that takes a lot of the stress off of not knowing what is going on. We take a quick ekg and if we don't feel confidant enough to read it ourselves or accept what the device says, then we email it to our doctor.

After awhile and enough feedback from the device and your doctor, you'll pretty much know without having to an ekg, but I always do both to make sure and to document it.

Jim

Puzzled8 profile image
Puzzled8 in reply tomjames1

Thank you Jim. Yes I’ve been considering the Kardia for a while and think now is the time to finally go for it. I was told my afib is now considered permanent. Does this mean the Kardia would always show me as being in afib ? Guess I really need to get one to find out.

Buffafly profile image
Buffafly in reply toPuzzled8

Yes it would, but it could also show that diagnosis is wrong! You should not be considered in ‘permanent AF’ unless you have had an unsuccessful cardio version to try to put your heart back in sinus rhythm. So if your GP said that they have jumped the gun, however, they may be right in thinking that your comorbities are the cause of your AF and so treatment is unlikely to be successful. Still, it’s not for them to say. If it’s any comfort, AF is not worse than your other health conditions.

Puzzled8 profile image
Puzzled8 in reply toBuffafly

Hi, gp sent me to A&E. They kept me in overnight to monitor afib and when consultant came round next day, she said looks as though afib has become permanent. I tend to agree with you that there is a possibility this might not be the case but will update after my cardiology appts.

mjames1 profile image
mjames1 in reply toPuzzled8

Yes, as long as you are in permanent afib, Kardia should show you as being in afib. Kardia has various models but I suggest the Kardia 6L. Seems more durable and for me has better connectivity. Also, if you want to, you can optionally take a six-lead ekg which can be more helpful for your ep.

Jim

javo123j profile image
javo123j

Personally I just know. It's chalk and cheese. The irregular pulse is my best way of checking but when it stikes it is like sudden illness. As other people have said a kardia can confirm it for you

Puzzled8 profile image
Puzzled8 in reply tojavo123j

Thank you javo123j. I seem to be mainly asymptomatic but do have periods of really heavy tiredness when I just have to sit and rest. I’m not very good at taking my pulse yet so need to practice that.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

I did get symptoms with AF is heart beating fast (and irregular). 187 breathless, weak, no energy sweating on Metoprolol. Charged eventually to Bisoprolol. H/R day 156. Still uncontrolled but no breathless, sweating and more energy.

Your Diltiazem will slow your H/R.

I wonder if you also need a low dose of BB like Bisoprolol.

I take only Diltriazem 120mg AM daily without food.

and Bisoprolol 2.5mg PM

You are taking a high dose of CCB Diltiazem. I was lightheaded with 180mg and H/R to 51. Changed to 120mg.

See what the H/Specialist says.

Doubling or raising meds is not always accurate to get you controlled.

Because my H/R Day is 60s I had my Right Shoulder done last Monday.

cheri JOY

Puzzled8 profile image
Puzzled8 in reply toJOY2THEWORLD49

Thank you JOYTOTHEWORLD49. I have a nurse appt this week to check bloods, heart rate etc to see how meds are affecting me and if any adjustments are needed. Your point about Bisoprolol is interesting. I was prescribed this first - 2.5mg - for tachycardia. It didn’t help so increased to 5mg but this made me feel worse and thats when they switched me to Diltiazem. I seem to be tolerating the increased dosage but maybe combining it with 2.5 mg Bisoprolol would be helpful.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply toPuzzled8

hi

yes.

I HAVE HAD AN ISCHAEMIC STROKE TOO.

4 years down the track i get fatigued but now not as much and stopping whilst walking.

dr says because the blod is not getting around your body fast enough.

CONTROL OF H/R IMPORTANT.

CONTROL OF BP ALSO IMPORTANT.

Anaesthetists will not operate if your heart is over 100bpm.

First h/r went down to 88-96 first introduction to twinked CCB DILTIAZEM 120mg AM DAILY.

AND 2.5mg BISOPROLOL.

A YEAR LATER 60s DAY H/R.

I LOST WEIGHT ON SOUR BREAD AND A2 MILK. WEIGHT LOSS ASSISTS AF.

CALL IT A CHALLENGE but being on the right ratio of meds is best.

CARDIOVERSION they will not do with a stroke patient and any abnormality of heart structure.

At one point dr raised bisoprolol to 10mg. it did little to my rapid day h/r.

cheri joy. 74. nz

Ppiman profile image
Ppiman

AF is a fast spasm or muscular twitching of the atrium at the top of the heart which prevents blood from being smoothly pumped blood down into the bottom ventricles. When AF is happening, the ventricles must rely on gravity and suction to get the blood they need to pump to the lungs and body, reducing their efficiency and potentially causing various problems to occur. The ventricles also often react to receiving disturbed electrical signals from the atrium by beating unevenly and, sometimes but not always, very quickly. This can also reduce efficiency and lead to symptoms.

This inefficiency not only varies between individuals but, tests have shown that individuals react differently to it (i.e. to having a reduced "ejection fraction" or EF). Some are said to feel incapacitated by their lower EF and others to remain relatively unaffected, even, it seems, not noticing it.

Add to this that anxiety, a natural result of the heart malfunctioning, can bring on a sense of panic and a feeling of "impending doom", but which also affects people differently, and the result is that some cope well with AF, even not noticing it, while others take themselves straight to A&E or dial 999, fearing the worst.

Steve

Puzzled8 profile image
Puzzled8 in reply toPpiman

Thank you Ppiman - that’s reassuring. I’d been wondering if I should be doing anything or contacting anyone. I seem to be asymptomatic and trying to carry on as normal, or at least my new normal. I definitely have to pace myself now and accept that I can’t get through as much in a day as I used to.

Ppiman profile image
Ppiman in reply toPuzzled8

My friend, now elderly, has had similar to you for very many years and never has had treatment beyond his warfarin tablets. If you’ve had an echo scan especially (which would show up things that matter on the longer term), or if all other tests have been fine and your doctor is happy with things, I think I’d rest easy! That said, resting easy isn’t something I manage easily, if ever.

Steve

Buffafly profile image
Buffafly in reply toPpiman

Hi Ppiman, your interpretation of the action during AF differs from mine - not suggesting it’s wrong but seeking more info. Could you post a reference please?

Ppiman profile image
Ppiman in reply toBuffafly

Hi there. Which part would you like a reference for? The study on the effects people feel when suffering varying EFs was from memory, and my explanation of AF effects was an everyday one, but it seems right for this context.

Steve

Buffafly profile image
Buffafly in reply toPpiman

The bit from ‘AF is a fast’ to ‘very quickly’. My understanding was that signals pass from the atria to the ventricles via the AV node and those signals (at a rate up to 400 beats pm in AF) can’t all get through fortunately and the rate of AF is governed by how many do. Not that the ventricles beat faster on their own, which would be ventricular tachycardia - I think?

Ppiman profile image
Ppiman in reply toBuffafly

Your description is correct. I had edited mine before your post so I have lost the original. I can't find out whether there's a pulse, as such, passing from the atria during AF (as opposed to Afl, say), rather than a jumbled mass of signals that bombard the AV node with only some reaching it and with most not being allowed through to the ventricles, creating an irregularly irregular and often fast pulse.

I think ventricular tachycardia must be the pulse that results from ectopic activity in the ventricles?

Steve

Thomas45 profile image
Thomas45

There are different types of AF. Paroxysmal is where you get episodes of AF, lasting from a few seconds to many hours. When I had paroxysmal I always felt it in my neck first.The other main type is Persistent, split into those who can feel their episodes which last more than 7 days, and those who cannot feel anything and have no symptoms. My AF is that type, persistent without symptoms.

Having said that, if you've learnt how to feel your pulse, you will be able to feel it.

The medical way is by an ECG, when sensors are attached to sticky pads around your body, mainly the upper part, to take a record of what your heart is doing.

My Persistent AF has been around for about 6-7 years, after about 22 years of the Paroxysmal AF. I consider my Persistent AF, now, to be Permanent AF. I don't think there's any way, medical or otherwise, that my heart will beat normally.

On the plus side AF is not life threatening, but those who have AF are five times more likely than others to have a stroke, and a debilitating stroke at that, so that's why we take anticoagulants.

Puzzled8 profile image
Puzzled8 in reply toThomas45

A very helpful response Thomas45. Thank you. I was sent to A&E by my gp and asked by drs there if I knew I had paroxysmal afib. Apparently it was on my medical notes after seeing a respiratory consultant just over a year ago. Someone forgot to tell me ! Stayed in hospital overnight and they advised me afib has now become permanent. Obviously then, like you, I am not aware of it. I feel reassured now and will have to practice taking my pulse.

Gumbie_Cat profile image
Gumbie_Cat in reply toPuzzled8

You can feel on more of an even keel when the AFib is persistent and ultimately regarded as permanent. I’m in that situation, and really just notice when I’m walking uphill or upstairs.

When it was still paroxysmal, I definitely had more energy when in sinus rhythm, and my heart bounced about in AFib and I felt worn out. Now the beta-blockers keep the rate from going too high, and I am relieved to be protected by anti-coagulants.

I did get a Kardia last year, but hardly ever use it now. My Apple Watch politely tells me each week that I’m in AFib 100% of the time. In some ways those of us who can’t feel it much are the lucky ones - as long as it’s been detected and we are protected from stroke.

Geoffa1 profile image
Geoffa1

Aah, that devil AFIB.Pre diagnosis sometimes I knew I was sick for no apparent reason, mostly I had no idea.

Post diagnosis, sometimes I knew I was afibbing, mostly I had no idea.

Post loop recorder I could accurately pinpoint only about 50% of proven events after the event.

I never found a proven trigger, tried to rationalise lots of things.

Post ablation and telemetry pacemaker, I know I have had no AFIB for three years.

Putting fact into the equation is the real AFIB challenge.

ozziebob profile image
ozziebob

If you are buying a Kardia device, I recommend the 6L model which produces ECGs with traces from 6 leads, and so provides more useful information (than the 1 lead model) for any medical expert who might be trying to "interpret" your ECGs.

Snowgirl65 profile image
Snowgirl65

I'm very symptomatic. When my heart takes off, it feels like a squirrel running around inside my chest trying to get out. Not very pleasant!

Karendeena profile image
Karendeena in reply toSnowgirl65

Just like me Snowgirl, I describe it as several ferrets running around. It's awful and I get the chronic anxiety with it too. I just wish the episodes didn't last as long, mine often go on for up to 36 hours! How long do yours last?

Snowgirl65 profile image
Snowgirl65 in reply toKarendeena

Hmmm... ferrets vs. squirrels. Hard to decide which I like (or dislike) the most! My episodes would usually be in the 6-8 hour range, but I've had some go up to 2-1/2 days. Those landed me in the hospital.

Karendeena profile image
Karendeena in reply toSnowgirl65

I dislike then both 😜Although squirrels have the bushy tails! 😜What do you take for it and have you had an ablation? I am waiting 12 months. I don't go to hospital as I was instructed not to unless I had chest pains or fainting and breathless

Snowgirl65 profile image
Snowgirl65 in reply toKarendeena

I have lots of squirrels here in my backyard -- they're fun to watch! If go into a-fib, I'm instructed to take an extra 50 mg. of Metoprolol Succinate. I've not had to do that since my last ablation in December 2022. That was my third ablation. We have no set rules here (in the States) as far as when to go to the hospital, as some people go into panic mode when they have a short bout of a-fib and hurry to the ER, like I used to do early on when I first started having episodes. It certainly is scary if you're not used to them.

Karendeena profile image
Karendeena in reply toSnowgirl65

Agree, I used to panic, now I just think 'here we go, I'm in for the long haul no matter how many deep breaths I take' 😕How did you find the ablation experience? I am dreading it as it's being done under sedation.

Snowgirl65 profile image
Snowgirl65 in reply toKarendeena

Is this your first ablation? Yes, very scary when your mind creates all sorts of scenarios beforehand. But all three of mine were easy as pie. I mentioned on this forum that I found a dental root canal procedure much worse. I don't know much about sedation as mine were under general anesthesia.

Autumn_Leaves profile image
Autumn_Leaves

The simplest way is to check your pulse. If it’s irregular, that’s a big clue.

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