If your heart rate is being controlled succ... - AF Association

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If your heart rate is being controlled successfully with drugs does your heart still beat erratically?


If your heart rate is being controlled successfully with drugs does your heart still beat erratically? It might seem a daft question to you old timers here but I was told by my GP mine was beating erratically when she took my pulse, but when she used a monitor to take blood pressure I glanced at the monitor and the heart rate was fine 71 bm which is fine for me. I wasn't at the surgery for my AF and she quickly moved on telling me I only had a ten minute appointment so we must deal with the main issue i came for.

15 Replies

I'm not medically trained Mickhall, but there is a difference between the heart rate and whether or not it is erratic or irregular. Most blood pressure monitors are not accurate if you have AF. Even taking the average from a number of readings for blood pressure can be a bit hit 'n miss but it is generally a guide. Similarly, if the heart beat is irregular, it may not necessarily produce an accurate heart beat reading. It is a good idea to take your pulse and count the beats for 15, preferably 30 seconds then multiply by 4 or double as appropriate to get a figure for the full minute. It should also be fairly obvious if it is regular or irregular. Most monitors now show an irregular or an erratic heart beat with a special warning on the machine.

As I say, I'm not medically trained so it will be interesting to see what others say..


Blood pressure monitors are not generally capable of registering AF and often give strange reading. the best judge is what you pulse is doing.

There are two types of dugs used in AF. Rate control to slow it down when in AF and rhythm control which tries to stop the AF from happening. If you go to AF Association website there is a booklet about all the drugs used in treatment of AF and what they do.

It isn’t a daft question at all Mick - many of us experience something similar.

There are a couple of things which can make the heartbeat erratic - the commonest being ectopic or early beats which feel rather like a skipped beat - everyone gets them and they are usually harmless. You could also be having very short runs of arrhythmia - a few seconds of AF or tachycardia but your overall heartrate isn’t too much affected by them.

If you feel well and don’t notice anything amiss, don’t worry. If you should be, are you anti-coagulated?

Yes Finvola i'm on apixaban twice daily anti coagulate, plus Bisoprolol, Diliazem, and Ramipril.

To answer your question, some drugs are intended to stop AF, eg. Flecainide, but they don't work 100%. You are not taking any of those though the ones you are taking will help by reducing your BP and HR.

Hi Mickhall - I am on the same drugs as you ( although recetly changed to Nebivolol from the Biso) and I have permanent AF. As buffafly says they help to reduce BP and HR to reasonable levels. My HR is frequently erratic but I do not take much notice of it now (had AF for 4 1/2 years) I can feel when it's going too high, so just take it slower, deep breaths ect until it settles. When I do take my blood pressure I have to do it about 3 times to get a average reading, as long as it does not stay high over all the readings I tend to ignore it. My body soon lets me know if things are going wrong.


rothwell in reply to cassie46

Just out of interest....if you have permanent AF would that not mean that your heart rate is permanently erratic? I thought that if you have permanent AT your heart rate would be irregular all the time as opposed to paroxysmal Af which is when the irregular heartbeat comes and goes.

Mickhall in reply to rothwell

Rothwell you have hit the nail on the head I suppose what I was asking is if you have permanent AF will your beats always be erratic even though the meds are keeping the heartbeat rate to a reasonable level ie between 60-90. I would also ask is it the erratic heart beat or the high rate when untreated which causes the damage or both?

Feeling for your pulse does not always tell you what the heart is doing. Spaces could mean extra beats, erratic could be AF, and sometimes things happen that you cannot feel when taking your pulse. Some heart pressure devices have a picture that shows when the heart is likely not beating properly and could be in AF.

I just purchased and Apple Watch and it seems to be quite accurate for reading pulse but is not accurate when in AF. It is much more accurate than the Garmin one that I purchased. It has a built in app that is useful. Some other Apps, such as HeartWatch, collect and present a lot of good information on your Apple phone. You can email this info to your doctor for example. I like it so far because you can see your heart rate throughout the day and night and what the heart rate is just before AF. Many of us know the heart often is beating slowly before entering AF. By setting an alarm, you get a warning and by moving to increase your heart rate you might stop the AF from starting. It also has workout, sleep modes, GPS, maps, etc which give you a lot of useful additional data. It does show when you have a high heart rate and often picks up the occasional short burst of erratic beats. And answering the phone, checking texts, emails, etc are cool too. I wondered if it would be worth the money and I have concluded that it is.

Ianc2 in reply to EngMac

' Many of us know the heart often is beating slowly before entering AF',

Interesting piece of information, I have a fitbit but it doesn't have this facility - what sort of heart rate do you set as a warning to move?


Hello Mickhall

Bob D Nailed it. I switched from a rate reducer to rhythm control (Flecainide) and I stopped having episodes of arrhythmia.

I was just on rate control( beta blocker) was taken off and put on rhythm control ( flecanaide) this added atrial flutter to my repetoire,so then they put me on both again! Seems to be working ok now after a settling in period.

Best wishes

Yes. Successful control does allow the heart to behave erratically. If you control too much so that there are never any irregularities you have gone too far.

A certain amount of irregularity is normal, and desirable. The heart is not a metronome.

See this thread healthunlocked.com/afassoci...

Hello Mickhall. I just had my 6 month follow up with my EP doc and my pulse is study between 70 and 80 BPM. I take metoprolol. My resting HR is 62 BPM. I have permanent Afib and the EP doc said that I am good to go even though my HR is erratic. I do take Eliquis for protection from strokes. I am lucky as I have no symptoms of Afib and found it by accident. Good luck in your journey.

Hi Lanc2, you can choose the alert setting that you want. I have it set at 50 bpm for the low and 110 for the high and 170 for the activity high. It will make a noise and vibrate when the settings are exceeded.

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