Afib or not afib

[Wilsons1990]

So where to start I'm new 27 year old male not overweight relatively fit ex-firefighter still go to the gym when I can.

Blood pressure always around 120/60

Ex smoker 10 a day quit 3 years ago

A year ago I was watching tv one night and got up to go to bed and felt a big ectopic beat and though ohhh what was that this made me anxious as I went upstairs eventually I became so overwhelmed with anxiety I passed out and fainted backwards over my bathtub much to the dismay of my wife.

We called NHS 24 thinking I'm having a heart attack which was laughable "oh you just fainted you don't need an ambulance" glad they were right.

But alas many gp visits and two ecg s showed normal heart rhythm and blood works normal but the anxiety of it happening again continued to cause distress and palpitations I had a 24 monitor fitted which was also normal dispite a few ectopics.

I went for a routine ecg and my gps request and I felt totally fine when having it done,I'd actually just been on holiday in two countries and been symptom free for two months.

Until they technician showed me the strip and said I have to speak to the doctor

"Atrial fibrillation with normal ventricular response"

I was so frightened at the prospect of being diagnosed with a heart condition at 27 with two young kids that I promptly fainted in the doctors surgery which was embarrassing.

The gp referred me to cardiology at the hospital and after some more ecgs and rhythm strips and monitors the cardiologist says my hearts fine and it's just some ectopics ?

My concern is was the ecg that stated afib mistaken? Is there many ways to interpret the results ?

Ideally I'd love an echocardiogram or something just to be able to put it all to bed it's the not knowing that drives me crazy

[BobD Volunteer]

All I can tell you is that computer generated diagnosis of ECGs is far too often wrong. It takes great skill and training to understand an ECG so I would accept what the cardiologist has told you and move on. There is nothing like anxiety to make your heart go funny. Ectopics are quite normal and everybody has them on average about 200 a day. Once you start thinking about them then you will notice them.

Enjoy your life.

[rosyG]

Welcome to the site. AF is easy to spot on ECGs and reading about your experiences I don't think you would faint because you were worried but much more likely that you fainted because you were having symptoms from the AF - which can come in short runs and by the time you get to see someone it's all stopped.

If you want to be really sure you could get a Kardia device(it fits onn your phone) and record your ECG if ever you feel anything is happening.

Did the cardiologist see the recording that had shown AF or is he saying it is just ectopics based on the extra recording they did. AF can come and go (called paroxysmal AF) so can be difficult to diagnose unless caught on recording

I hope all goes well for you and thing settle down Try to relax and do deep breathing if you feel anything is starting up as anxiety can make it escalate Good luck and let us know how you get on

[Wilsons1990 in reply to rosyG]

The cardiologist did see the ecg with the afib computer diagnosis on it hence he requested a further ecg and holter monitor he then said there was no evidence of afib on the two tests he carried out other than ectopics he then stated he suspects it was these ectopics that were responsible for the abnormal ecg the computer diagnosed as afib, my heart never races or anything I've read a lot about the symptoms since, fluttering dizziness racing heartbeat I never experience any of those if anything my resting heart is quite slow 50-60bpm it's been as low as 45bpm when I'm relaxed which traditionally is bradycardia but none of the doctors even took a second glance at the rate being that low at times

I was lucky enough a doctor listened to my heart and my pulse at the same time as I was having one of those anxiety episodes right after fainting having been in a gps practice and he said it was a vasovagal syncope ? Or something like that not sure on spelling akin to someone with a fear off needles fainting at the sight of a needle.

[Amcech in reply to Wilsons1990]

My son, 28 years old, has the exact same problem as you. He definitely passes out from anxiety, he passed out at his wedding and in college when giving speeches or when he is overtired, his tests have been fine too. They only heard a small murmur one time, which I wonder if that really exists. I do have persistent afib for the past 8 years. So I don't know if my son will develop afib too, just never know. The most important thing, and the hardest, is not to worry. Worry causes stress and anxiety which can make your symptoms worse. Good luck!

[fib4]

sounds like what I've been going through tests always come back negative but still have irregular heart beat

[Kisswendy4me]

Anxiety causes all of the things you mention above Wilson. The body is a funny thing, how we respond to it is critical to how it continues to respond to us.

[Hidden]

Difficult. Do you have a history of anxiety or fainting before all this kicked off? Anything else on your mind? Not suggesting anything, just asking.

Get copies of the letters from the cardiologist to the GP, to be sure you have not misunderstood.

Get a copy of the ECG reported as AF by the computer, and post it here.

Normal tests in this context don't rule out a problem, but they make one less likely.

Persistent anxiety about worst case scenarios, can create a problem far worse than the original one. My experience was that information was self empowering and CBT was helpful, if not the complete answer to my anxiety.

I am by no means suggesting this is all in your mind. Far from it.

So far nothing seems definitely to have been ruled in, or out. Diagnosis remains an art rather than a science, even if less so than previously.

[Hidden]

It could be a syncope issue but that would only be evidenced by a tilt table test, but that's a separate issue from AF.

[Hidden]

Having a heart condition sounds pretty dire but actually AF is not so much something wrong with your heart as a fault in the heart's electrics. It can be anything from an occasional wobble to a full time malfunction and it can be mildly annoying to very intrusive. Some people are unaware that they have an irregular pulse.

We all have our own variety and we get to know what to expect and how to deal with it and we go through the ranges from disruptive and there all the time to occasional AF that's not very disturbing.

Perhaps you are one of us, perhaps not. AF is easy to see when an ECG captures it but it can be very elusive. The thing is, don't think of AF as a terrible, life ending illness. It's an unwelcome condition, yes, but it can be very manageable and treatable and has a few benefits like goading us into living well and not doing naughty things.

[IndiraK]

In answer to your question about whether AF can be mistakenly diagnosed from an ecg - I had a diagnosis of a 2min run of AF from a 7 day monitor assessed by my GP's surgery. On subsequent evaluation of the same results by a private cardiologist there was no clear AF but a 'cluster' of atrial ectopics.

The very best thing you can do either way is to take the advice here regarding measures to reduce anxiety so that you can minimise its impact on you. All the best.

[Hidden in reply to IndiraK]

Hello again Indira

You have said previously that you have a diagnosis of multifocal atrial tachycardia.

My experience is one of being told by my EP that current practice is not to ignore supraventricular tachycardia variants. When I developed AF, I had a 30 year history of SVT which was managed expectantly, without any treatment. I assumed the inference was that with hindsight that was a mistake, even if within guidelines at the time.

Atrial tachycardias are not AF, but AF may emerge many years later. Just making the point that what seems trivial now may become significant eventually, the operative word being may.

[IndiraK in reply to Hidden]

Yes Badger. My cardiologist describes it as my having 'a pre-disposition' for AF but no clear sign of it currently. If anything changes I will return to him for a diagnosis.

The tachycardia was not evident on the 7 day monitor I refer to above but developed later - in my view as a result of anxiety about whether my ectopics were developing into AF. I am taking 1.25mg of Bisoprolol which I intend to stop after Christmas sometime and use as a PIP unless the ectopics impact quality of life too much.

Any thoughts you have on this are most welcome.

[Hidden in reply to IndiraK]

As a lot of us have reported, a betablocker can be useful in part because it tends to help with anxiety. I believe bisoprolol is prescribed in AF primarily for it's rate control effect, although it can work independently as a rhythm control drug PIP

Others will know whether it can work effectively as PIP for ectopics.

[rosyG in reply to Hidden]

No it’s a rate control drug

[Hidden in reply to rosyG]

Hello again Rosy, season's greetings 🙂.

Yes Bisoprolol is certainly a rate control drug in the context of AF and other dysrrhythmias.

All unselective betablockers slow the heart to a greater or lesser extent by acting on the SA and AV nodes, and therefore by definition are rate control drugs. Bisoprolol, which is cardioselective, has been shown as effective for PIP rhythm control in PAF but is not used so much in this way in the English speaking world as Flecainide, Propafenone and Sotalol which are preferred for rhythm control. Amiodarone is also very effective but longer term serious toxicity issues tend to limit it's use.

Have you found that members of the board report much success with bisoprolol PIP in managing ectopics?

I think that may be the more interesting question in the context of this thread .

Happy New Year ! 🙂

[Wilsons1990]

I was prescribed propranolol 10mg 3 times a day for anxiety before the afib ecg after the computer generated afib with normal ventricular response result my gp prescribed me 5mg bisoprolol instead of propranolol, and checked the guidance on blood thinners but he decided not to prescribe those until after consulting cardiology as he said my risk factors for clots were extremely low apart from afib.

The cardiologist then said he thinks my anxiety and 1 abnormal ecg result was caused by ectopics. I think I'm going to request copies of the ecg strips.

He suggested I can stay on the bisoprolol if I wish as they may help against ectopics and anxiety and I have 1 pill before bed a day.

[Hidden]

An echocardiogram cannot diagnose arrythmias, only the EKG and other forms of monitoring your heart’s electric activity. You can have a very severe episode of AF and the echo would still be normal. You probably suffer from anxiety (panic) attacks. During the attack you might have ectopics and lighheadeness with fainting from hyperventilation.

[rosyG in reply to Hidden]

best to monitor so you can be sure as we are all second guessing a bit!! It's important to get a diagnosis so you can have relevant treatment If affordable, a Kardia device would be good- you can email the recordings to your cardiologist

[Hidden]

If my doctor had ever told me that the tests did not show any evidence of arrhythmia, I would have become the happiest man on earth and might have taken a holiday. Rather that play detective and conduct my own investigation in order to prove that the doctor was wrong. Why should I be so eager to become a sick person?