Going into NSR from AF

More times than not just at the point when I go back into normal rhythm after being in AF I experience a really unpleasant feeling, I think it's called asystole, I get completely dizzy and feel like I'm going to pass out and feel really disorientated. It probably lasts only a few seconds but feels like forever when it's happening. I think it's my heart jump-starting itself to come out of AF, it's even been monitored on a trace when I had called an ambulance and while the ambulance paramedics had me hooked up to their portable ECG machine. I had the same experience but milder when given Adenosine in A&E once, when the doctor wanted to see if the tachycardia I presented with was actually atrial flutter.

Yesterday morning it did it again. I had taken 2.5mg Bisoprolol and 100mg Flecainide as a pip about an hour after the AF started (about 1.30am), as advised by my EP, and I know this can sometimes lower my BP before it wears off but this is something very different. I did an Alivecor reading twice as soon as I could after I came round, as it were, and each time it showed long lines inbetween the regular heartbeat recording, even though the readings showed as normal.

I just wondered if anyone on here experiences the same thing when they go from AF/AT into NSR? I'd be grateful for any feedback, thoughts, advice etc.

Thanks, Kate

12 Replies

  • I had presyncope (near faint) every time I went from AF back to normal rhythm which was caused by a slight pause of a few seconds between AF stopping and normal rhythm resuming. I had a pacemaker inserted in March 2014 which solved the problem

  • Yes, I posted about it quite recently. I was also able to see it on an Alivecor trace, explained what my 'little dizzy spells' caused by! Showed it to GP, appointment to see cardiologist came through for 6th August so I guess he is not too bothered......

  • I too feel faint and dizzy when jumping between the 2 . I'm so used to it now that I seem to sense it starting and just try to make sure I'm sat down till I settle

  • It could be sick sinus syndrome? ie - heart pauses, fits the symptoms. How long are the pauses between beats?

    Suggest you get the ECG trace looked at by your EP. Have you sent the Alivecor for analysis?

  • Thank you for your replies, good to know it's not only me who experiences this.

    I guess I'll follow your advice, CDreamer, and get the Alivecor trace sent to my EP and see what he says. Mind you, this has been happening on and off for a couple of years now, I'd always put it down to the meds but maybe not. The paramedics and A&E docs didn't seem that concerned, and my GP merely suggested I spend £50 on a BP monitor! However, as I'm now waiting for a 3rd ablation maybe it would be helpful info for my EP prior to having it done.

  • I had the same problem. A 7 day halter revealed that when coming out of an episode of AF into NSR my heart was not beating for between 3 and 10 minutes, which was causing the dizziness and fainting. I was urgently fitted with a pacemaker and have had no problem since. I remain of course on flecainide and bisoprol plus anticoagulant. My NSR resting pulse before the pacemaker was fitted was around 45 to 60. When the pacemaker was fitted they set the rate at 60 which is where it has stayed. One unexpected advantage of the pacemaker was that it records the amount of time spent in AF which can be found out at the periodic pacemaker checkups with the technicians, who have an instruction to notify the EPs if the percentage rises above a certain level. All this provides reassurance which means I do not monitor my situation and often do not bother noticing when I am having an episode of AF.

  • Going into NSR

  • Thanks for the really helpful and informative post, something to think about and I will contact my EP to see what he thinks. I guess if having a pacemaker fitted helps, and as you say, you often don't notice when you're in AF, then perhaps this is the route I might have to consider going down.

  • Sorry, in my earlier post, should have been 3 to ten seconds not minutes!

  • No worries, I thought you might have meant that after reading your post through again.

  • I have had the same issue (dizziness as heart pauses for 3 to 5 seconds when going back into Normal Rhythm after AF). One cardiologist suggested I might have Sick Sinus Syndrome (long pauses combined with normal resting pulse in the 50s or even 40s) which requires a pacemaker to help resolve. My EP, though, said it is not unusual for the heart to pause when coming out of AF back into NSR and that even if I do have Sick Sinus Syndrome, he would not recommend a pacemaker unless my symptoms became much worse (closer to passing out). Having just gone through an ablation 2 months ago, I am hoping these episodes will not occur since I will have fewer AFs.

  • Thank you for your post, jeffer, it does help to know that a pacemaker may not be necessary or the only option to sort this out. Fingers crossed the 3rd ablation will do the trick.

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