Low heart rate AFIB

[tinhouse]

My younger sibling was diagnosed with AFIB and is on Eliquis and Metoprolol. She has frequent episodes, but always converts. Her heart rate never goes above 90 when she is in them. Is this true AFIB? Because of this she never communicates with her EP because it doesn't bother her. Is this damaging her heart, going in and out of AFIB every day. She cant tell if she's in it or out of it so she just ignores it. I am six months post ablation and doing well but my AFIB and Flutter was in the 120-160 range and I knew it when I was in it.

[Globe-J]

Hi T.......

From what I know (have been there) the danger is an increased risk of a blood clot formation, causing a stroke of a heart attack. My cardiologist suggested that the danger is higher than if one is in a permanent AF

Best wishes

J

[CDreamer]

Agree with Globe the risk is increased risk of clot forming in the Atria and travelling to the brain causing stroke - that is why the first line treatment is always anticoagulation.

Any treatment after that is for improved QOL so if it doesn’t bother her - and most people in permanent AF don’t have the degree of symptoms that people with PAF seem to suffer - then I was told there is no danger.

AF is determined by the lack of a P wave on an ECG and not on Heart rate. I’ve had both slow and fast AF - I can cope almost normally when HR average is less than 120 - when it goes over that then yes, I become very symptomatic.

You don’t say age - just younger. Age may have a bearing on long term affects of AF.

I am just wondering if she is in slow AF - why the Metoprolol? I don’t take any drugs other than anti-coagulants.

[BobD Volunteer]

Slow AF is still AF but probably does not need treatment as the risk to the heart is reduced by the lower rate so if she is not troubles by it and since she is on anticoagulation then as my lad would say "everything is gravy". As CDreamer has said, apart from anticoagulation, all treatment for AF is only about improving QOL.

[Polski]

The metaprolol is a beta-blocker which will be keeping her heart beat low, and the Eliquis is an anti-coagulant to prevent strokes, so her AF is very well-controlled (so shouldn't damage her heart) although frequent. If she is happy, then why bother an EP?

However, if it should become permanent they may not be willing to do an ablation, which she may come to regret. I wonder how frequent her episodes were when she was put on these drugs? If it was much less frequent then than it is now, then she may want to seek an EP's wisdom.

[daved525]

My EP always says "afib begets afib". There is a theory that the heart remodels during afib, making future episodes, and persistent afib, more likely. I would consult an EP.

[Kaiser78]

I once had af that was going around 50 beats per minute, it was weird lol

[sdalen]

Yes, one can have afibs without the fast heart rate. Rarer duck but still there. Blood thinners are the usual route but now they have The Watchman device and/or left atrial occlusion if you cannot tolerate the blood thinners. Anyone with fibs should check their diet, lose weight if over weight, do 30 minutes a day of walking, consider stress management, also consider sleep apnea (a major cause btw) and getting a good sleep as well. Inflammation is a big part of heart health and reducing that is critical.