Bradycardia still not sure

I am a 67 year old female and have been diagnosed with AF a year ago after having a TIA which came out of the blue. I was full of energy and thought to be very healthy. I am reading all your great comments and advise and I am hoping someone will be able to give me some information. I am taking perindopril and Apixaban, no other meds. Sometimes I think it's the medication that makes me feel less energetic but that's most likely not the case. My heart rate is on average 55.

Sometimes 45and rarely 35 but never over 60. I hear my irregular pulse 24 hrs in both of my ears. My energy level is up and down . Some days I feel fit and healthy. Otherwise I don't have any bad symptoms. But any sort of excitement, good or bad gives me a jelly like feeling throughout. That is the best way I can describe this.

I was told that I have AF but due to my irregular rythem beta blockers are a no for me. I do understand this and I did read everything about AF and Bradycardia what I could find but nothing really fits. I am unsure and anxious what is really wrong with me or am I very lucky at the moment and things will get worse in the future.

I do hope this isn't too confusing and someone has a similar problem and can put me more at ease.

7 Replies

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  • Hello and welcome to our world.

    First a few corrections. beta blockers are not out because of your irregular rhythm They are out because your have bradycardia. Because your heart rate is already low (sub 60) beta blockers may well reduce it to a dangerous level.

    The abixaban as I am sure you know is an anticoagulant to hopefully prevent any further strokes or TIAs since it is doubtless your AF which triggered the TIA which you had.

    AF is a mongrel condition which affects us all in different ways and at different levels. Drugs do often cause weakness and loss of energy and it is often necessary to try several different ones before a "match " is made.

    I am not aware of your location but in UK if your doctor has not been able to help with your symptoms then you should see a specialists called an electrophysiologist who is a cardiologist with special interest in rhythm problems. This is your right.

    Read all you can from AF Association website and ask here and we will try to help.

    Bob

  • Dear emsling, I have AF with bradycardia. I was diagnosed with this in 2013 and like you I have good and bad days and symptoms that are sometimes hard to describe. For the past year I have felt relatively well but stress at work and my not listening to my own body telling me to slow down ended up with me being quite unwell for a month. I am my own worst enemy as I used to constantly being rushing around and trying to adjust to a slower pace of life remains challenging!

    Like you I cannot take beta blockers as my heart rate would be too slow. My average rate is 45 which can drop to 35 overnight (recorded on Holter monitor). My rate rarely goes above 60 now. I take Rivaroxavpban as my consultant who is an Electrophysiologist felt the risk of stroke was high. An echocardiogram showed severely dilated left atrium, my ventricles have not been damaged as not all electrical impulses are being transmitted by the atrial ventricular node and through the Bundle of His. I have been told I have disease within the sino-atrial node and Bundle of His (infra-Hisian disease). My EP said this is very rare and either hereditary or congenital condition and he suspects I probably lived with it for years, condition being missed or mis-diagnosed.

    My reaction to cardioversion confirmed my diagnosis, or that is what I have understood - 7 second pause and heart rate slowed to rates outlined above. I have been advised about potential options to treat but at the moment just being monitored. For the most part I lead a full life, all be it at a slower pace, although I now admit to having led life at a crazy pace! I am aware I need to keep my weight down, eat a healthy diet, deal better with points that can be stressful (stress and AF not good partners)! I used to suffer with insomnia which I have worked hard to resolve and for the most part I manage to achieve a good nights sleep, if this gets out of hand for a short spell I am aware it has a negative impact on my cardiac symptoms.

    This forum has been an amazing source of support and information. From what i have read no two people are exactly the same and getting a diagnosis and assessed by an Electrophysiologist is very important so that treatment and management of your condition is specific and relevant to you.

    I have chosen to take supplements of Magnesium and CQ10 which I feel have been beneficial but I suspect it is a combination of looking at and addressing lifestyle issues that has had the most beneficial outcomes for me.

    Would be happy to share any other information of you have any questions. Wishing you all the best.

  • Thank you so much for your reply. I will ask my GP to refer me to anEP. I have been trying to find onrone here in the West Midlands. My GP has no idea if this beneficial for me just thinks I should see the cardiologist again if I get any symptoms.

  • Definately see an EP they are the specialists who have the most knowledge about AF and will know which are the most appropriate investigations and guide you with options for treatment. I wish you well. I know I was very scared at first but have learnt to try and keep anxiety under control as that exacerbates my symptoms. Others on this forum are very supportive and always helpful if you need some words of reassurance - they have helped me no end.

  • Hi there

    I have Bradycardia and AF; I used to get fast AF episodes with rate >200. Mine has been described as Sick Sinus Syndrome but can be described as Brady/Tachy when rate alternates between a low heart rate and AF. It's not so common but not rare there are quite a number of members with similar issues.

    Bottom line is that you do need to a heart rhythm specialist (EP) and have them work out your specific issues and the right treatment plan based on that. That I know of there are anti-arrhythmic drugs that don't lower the heart rate like a beta blocker; there is ablation treatment for AF or pacemaker that would allow you to take beta blocker drugs for the AF.

    When you have this it is more complicated and the treatment options will depend on your personal circumstances and choices. Members have had any of these; I choose to try ablation (I was on anti-arrhythmic drugs in the meantime) and after 2 I do not have fast AF now. I have been able to come off all drugs for now. I won't be able to have another ablation so when I get symptomatic with the Bradycardia or the AF then I will have to go with the pacemaker option.

    Just one thing I would add is if you start to have episodes where you pass out or feel like you are going to you need to see help more urgently as this could be a sign of pauses in the heart beat.

    Get your GP to refer you to the specialist EP not a general cardiologist and go from there.

    Take care and keep well.

    Jo

  • Thank you Jo. That is very helpful.

  • heartrhythmspecialists.org/...

    Looks like Queen Elizabeth hospital have a team.

    Jo

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