A silly question perhaps, but you have an A... - AF Association

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A silly question perhaps, but you have an Afib episode without the palpitations?

Roobydooby profile image

Hi all

Following a stay in hospital, I was eventually diagnosed with paroxysmal Afib on 1 October this year after 18 months of symptoms. I found this forum & posted about my anxiety of getting this diagnosis & received much advice & support, so I’m back for more!

Since 1 October I’ve been taking Fleicanide (50 mg x 2 daily) & Rivaroxaban (20 mg daily) & have had no palpitations whatsoever, can’t believe it, heart is ticking along nicely, although faster than it used to (averaging 75-80 bpm). Fleicanide seems to be a wonder drug! However for the last 3 days I’ve been feeling unwell, actually feel as if I’m having an Afib episode but without the palpitations, have the pounding in my ears, feeling of heat in my chest & generally lethargic, exactly as I used to get with an episode. My question is this, could it still be an episode even though I’m taking the Fleicanide?

I’d also be interested to know if anyone else experiences the feeling of pounding in their ears, I’m wondering if this is a symptom of Afib? It drives me to distraction, 24/7 constant pounding, stops me sleeping even though I have relaxation music through my headphones. My GP dismissed it when I mentioned it to him.

I should have had a follow up outpatient appointment with the cardiologist at the beginning of December, I have a list of questions ready for him, but no sign of anything even though I’ve chased it up.

I think I was just about getting my head around this thing, but this has set me back, feel like I’ll never be able to forget about it & get on with my life.

Perhaps I should also add that for the past year I’ve had no alcohol (not even at Xmas!) & drink decaf tea & coffee as I know these could be triggers for Afib.

Thanks for reading this



13 Replies

Well it sounds like it. Your cardiologist/electrophysiologist may try you on a larger dose of Flecainide.

A Kardia device might be a good investment; occasionally Flecainide can precipitate atrial flutter.

Perhaps have a word with the arrhythmia nurse?

Roobydooby profile image
Roobydooby in reply to

Thanks for that, will look into it

Re. your GP dismissing your concerns.Go to another doctor in the practice.....or if you can afford it,try a one time visit to a private cardiologist/electrophysiologist.Plenty of advice as to whom to consult will be offered on this site.Also. Chasing up appointments,in my book, means ring the dept., at least once a week and ' piling it on' so they really get a picture of someone feeling extremely unwell.Do not let up.

Thanks for the reply, I actually paid to see an electrophysiologist in February this year (had seen him once at his NHS clinic but was waiting so long for a follow up appointment), he told me I didn’t have Afib but eventually agreed to fit an internal loop recorder “to put my mind at rest”. This captured several small episodes & then the big one that resulted in a hospital admission & a diagnosis of Afib. I’ve since been transferred to a different cardiologist. Re the follow up appointment, I now have the cardiologist secretary’s number so will do as you suggest!

BobD profile image

Just to be clear about this..... Palpitations is a medical term which just means that you are aware of your heart beating. Many people with AF are asymptomatic and quite unaware of it so be definition are not aware of any palpitations. In fact many only find out that they have AF when the stroke hits them sadly.

Flecainide although an anti-arrhythmic drug does sometimes cause arrhythmias so it is possible that your symptoms are as result of the drug ... or not. The only real test is an ECG or implanted loop recorder sometimes called a "Reveal" or in some cases a Holter monitor worn for several days prefferably.

What you are hearing in your ears is known as pulsatile tinitus and again quite common for us AFers and as I know can be highly annoying. One can learn to "dial it out" but it takes determinatiion and does not always work.

Roobydooby profile image
Roobydooby in reply to BobD

Thanks for that Bob, I have an implanted loop recorder so I suppose it’s picking everything up. I guess I’ll have to learn to live with the tinnitus!

I was asymptomatic in afib even at 130 to 190 or above.

Since my ablation I have on occasions got worried it may be returning because I felt a missed beat or some other resson and I get highly sensitized and can hear my heart beat, especially when trying to go to sleep and it prevents sleep. This makes you feel tired. Add in a bit of a worry and you are on a downward spiral. Only way to know is to get an ecg done, so unless your GP has one then it's a hospital trip.

If i was you I would do it sooner rather than later to set your mind at rest.

If you are intermittent then on ecg may not pick it up . However from what you say you feel tired all the time now, so if a fib is the reason then you would think it should be continuous and obvious.

Best wishes

Roobydooby profile image
Roobydooby in reply to KMRobbo

Thanks for the reply, yes I think I have become highly sensitised, need to learn to relax!

Hi rooobydooby, I get small afib crazy’s according to my cardio that the 24 holster picked up and I didn’t know about them.....plus I have had a few proper horrid afibs........like you Flecainade has seemingly been my sabiour and I’ve been calm once I took that.....but I do some days wake up tired out and just feel I can’t walk in town with the energy I normally have..and have to rest all day pooped...I put that down to the silent afibs I dont know about .

It’s horrid with this if you get worries and there no bavk up.....I hope you get to see someone soon.

Roobydooby profile image
Roobydooby in reply to Morzine

Thanks Morzine, I’ve just had to rest for the past couple of days & it (whatever it was) seems to have gone, until the next time!

I too have pulsatile tinnitus. You will get used to it I can assure you. Sometimes it’s quite soothing to go to sleep hearing that strong steady beat rather than something sounding like the end of the 1812 overture.

Thanks Hylda, that made me laugh!

I have PAF and sometimes get what you describe. However, difficult it is (and it is very difficult) try to relax - otherwise you will set up a vicious circle of anxiety and heart palpitations. Bear in mind that even when you relax, it may take some hours for this to impact on heart palpitations. I have also found that eating large meals and/or a lot of sugary foods like

biscuits tends to make this sort of thing worse. Try to stick to a plant-based diet.

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