Just diagnosed with Atrial fibrillation

[JennyP2017]

Hi I was diagnosed with A-fib a couple of weeks ago via an ECG trace on my Kardia mobile. I am now on Apixaban 5mgs twice daily and Atenelol and have been advised that an ablation is the best way forward. I only have had 3 episodes to my knowledge and so it paroxysmal but makes me feel pretty unwell. Any advice or support would be so welcome as this has completely thrown me especially since when I was admitted to A&E they did tests, I showed them the same ECG trace and they told me I did not have A- fib. Had an appointment with a cardiologist 2 weeks later who from the same ECG trace from my Kardia mobile told me I have so to be honest I am in shock really. Any advice or support would be so so welcome. Thank you.

[Engineer46]

Hi Jenny, welcome to the forum!

A Kardia device (or any similar home ECG) cannot usually unequivocally diagnose AF, but is a good indicative tool. It's very useful in your case of Paroxysmal AF, because you may be out of AF by the time you are given a clinical ECG but you can show your readings to the doctors.

However, for AF to be confirmed, the heart beat needs to be irregularly irregular (no discernible repeating pattern) and there should be no "P-waves" (a very small peak just before the QRS complex). This last part is hard to detect on a home ECG because the signal is often noisy and this can obscure any small waves. This may help to explain why the hospital and the cardiologist had differing views.

In addition, when in AF the heart tends to beat faster than usual - but this varies widely from patient to patient.

I have permanent AF but thankfully it has always been symptom-free. My unmedicated heart rate in AF was just over 100 so I now take the lowest dose of Bisoprolol (1.25mg) which keeps it around 85bpm. I also take 60mg Edoxaban for anticoagulation, having switched from Apixaban earlier this year (only one tablet per day required with Edoxaban instead of two with Apixaban). I have had no side effects from any of these drugs.

As I have permanent but symptom-free AF, I have not been offered or requested a cardioversion or ablation, but there are many members here who have had these procedures ao hopefully you will get some support from them.

I was interested in why you had a Kardia in the first place, as it tends to be something that people buy after they have been diagnosed with a heart problem.

Best wishes,

Paul

[JennyP2017 in reply to Engineer46]

Hi Paul, thanks so much for your reply. I have actually requested a second opinion as two diagnosis of it not being A fib and one saying yes before I go any further forward with the possibility of an ablation I need to be one million per cent sure it is A fib. I also am being fitted with a 7 day ambulatory ECG tomorrow. When I took the ECG on Kardia that day I was in a real panic too and it was just before we had to call the ambulance so I do wonder if that had a bearing on the trace as well as I must have been just a tad shaky!! I am so pleased to hear that your AF is symptom free and well controlled. The reason I had a Kardia mobile was that I have always had some bouts of tachycardia over the years which were thoroughly investigated and nothing to worry about but they became very frequent after two things - firstly the 2 Covid vaccinations after which I ended up in hospital A&E both times with fast heart beats and so never had any boosters as advised plus the HRT shortages kicked in and I was changed from pillar to post to different types of HRT plus different doses and I understand oestrogen can affect heart rhythm too so that is when I got the Kardia mobile. I never had anything over the years other than tachycardia and normal sinus rhythm which is why the AF thing floored me. Anyway hopefully the second opinion may finally sort things one way or the other but in the meantime I am on Apixaban and the beta blocker so the stroke risk is being treated should it be it. Thanks again so much for your reply

Kind Regards

Jenny

[Engineer46 in reply to JennyP2017]

Jenny,

Hopefully the 7 day ECG will help, but you may not have an AF episode during that time.

The next time you do have an episode, if your Kardia isn't to hand, just take your pulse manually- you should be able to tell the difference between a fast regular beat and a fast but very irregular beat quite easily.

[JennyP2017 in reply to Engineer46]

Thank you that sounds a very good idea I will do just that

[Morningrose]

Hi, I was diagnosed with paroxymal AF in 2017. It has been contolled like you, with Apixaban 5mg twice a day. I was also given Bisoprolol starting with 2.5mg and went up to 5mg and this year it was increased to 7.5mg. I had two bad episodes of accelerated pulse last November, 147 and 149. On the 2nd occasion, I was given an intravenous of Magnesium to try and bring my pulse down. On both occasions, my Troponin level was fine and was able to go home. Mine, so far, has been manageable by tablets but my Cardiologist had mentioned ablation which I am not so keen on as I have read other people on this Forum say it made their condition worse. We are all different of how we react to meds and procedures and it may come a time when I will have to have it done. I take 1 tablet (200mg) of Magnesium Citrate daily along with Vitamin B12 and D3 as recommended by my Cardiologist. I hope my experience of Paroxymal AF helps you some way and wish you the very best.

[JennyP2017 in reply to Morningrose]

Morning Rose thank you so much for your post really appreciate it. Such a minefield isn't it. The cardiologist I saw told me that he now recommends ablation as a first line of treatment if risk factors are sufficiently low i.e. not diabetic, don't smoke etc and the heart is structurally sound. Like you I am somewhat nervous of ablation and as my AF was only diagnosed via the Kardia mobile I feel like I would like some more definitive proof first before making any big decisions. As I mentioned I have asked for a second opinion and my Dr did mention they might fit a loop under the skin which records heartbeat all the time as mine is paroxysmal so the 7 day ECG may well miss any AF episodes. It sounds as though you are getting good treatment and I hope so much you continue to stay well and do well as you are. I wish you the very best too and thank you again for posting x

[Morningrose in reply to JennyP2017]

Hi JennyP2017,I am not medically trained but I still believe that ablation should not be the first mode of treatment. A tablet based treatment should be tried first. If that fails, ablation could well be on the cards then. I hope you get the right tratment which will help living with PAF easier. Thank you for your good wishes. Wishing you all the best. Take care. 💜

[MoundMan]

Perhaps doesn't pertain whatsoever: experience with 2 ablations has been favorable. Am across the big pond. Slow afib has been with me since childhood. Symptoms of fatigue only began 8-9 years ago. 74 now. Slow afib is what my heart knows. 'Understands' as "normal." Tries to return. As precaution, take blood-thinner xarelto and rhythmol. Advice you've received above is far more solid and detailed than this generalist can off.