AF and pauses in heartbeat

[Suzy1954]

Hi everyone. I went for yearly check up at cardiology clinic yesterday. I mentioned I was having episodes of feeling like my heart beat was pausing for a few seconds. I have persistent AF. Doctor said it could be the beta blockers, it could be you’re going back briefly to sinus rhythm, or it’s just what can happen with AF. Last year a loop recorder was mentioned but on the screen my cardiologist, who wasn’t in clinic had written, he wouldn’t fit one unless I was passing out during these episodes. He said if they start happening close together then they would recommend a 14 day Holter. I wondered if anyone else had had this problem?

[beardy_chris]

I had an episode of syncope (passing out) last year when my heart stopped for longer periods (max documented at 27 seconds!) and ended up with a pacemaker. If you aren't passing out, it probably isn't too bad but it might be worth keeping track of what you were doing when you feel these episodes and seeing if you can spot any common factors.

[Suzy1954 in reply to beardy_chris]

Hi Chris. Yes I’ve decided to document when they happen. How do you get on with your pacemaker if you don’t mind me asking ?

[beardy_chris in reply to Suzy1954]

It was a bit sore at first. It stops me from passing out which is its job. The funny thing is that people keep saying to me "Do you feel better now you have a pacemaker?". The honest answer is I feel exactly the same but I stay conscious - which is a benefit!

No long term problems at all and it's 9 months now.

[Suzy1954 in reply to beardy_chris]

That’s good to hear. Like you say it’s doing the job. 👍

[Suzy1954 in reply to beardy_chris]

Another thing Chris. Do you feel your pacemaker kick in if needed and has it stopped your episodes of pauses?

[beardy_chris in reply to Suzy1954]

No, I can't feel it doing anything and, yes, it has stopped any pauses.

[allserene in reply to beardy_chris]

27 seconds ! Heck Chris I had 5 lots of 5 second 'gaps' in a row ....and it scared the bejaysus out of me and I saw a shrinking cone as i went towards passing out ...but didn't. Off to see my electrophysiogist in 2 hours time (first visit). My only episode was early April with nothing since and I am keen to get off eliquis anti-coag as it is expensive. It kicks in in a couple of hours(not like warfarin), so I can anti-coag myself almost instantly if I got another episode.. Well, hats my prepared story so I will see what he says.. 27 seconds in heavy stuff so you look after yourself and pester them...

[Talika in reply to beardy_chris]

I had the same

[Buffafly]

Yes, though I have PAF. I had some pauses up to 5 secs recorded on Kardia. It was suggested it was the meds, and I would have to have a pacemaker if I wanted to keep taking them, or try an ablation. I had the ablation, not totally successful but now I only take the lowest dose of Diltiazem. A 7 day holter didn't show tachybrady syndrome bad enough to warrant a pacemaker so bumble on! Unfortunately I am still having occasional episodes of faintness without actually passing out, not sure why but of course can't drive 🙁 I think making notes of episodes is a good idea and I should do the same. Not fun, is it?

[Suzy1954 in reply to Buffafly]

Hi Buffafly. Would you be able to drive if you had had the pacemaker? Or did they refuse to fit one because your pauses were not that bad?

[Buffafly in reply to Suzy1954]

Tricky one. I didn't have any dizzy spells while I had the monitor so no justification to fit a pacemaker as my lows and highs were acceptable. Lately I have had quite a few fainty spells but sod's law says if I have another monitor I'll be fine that week. So I guess I'll have to wait until things get worse or more frequent. My episodes happen when I am really relaxed so maybe heart slowing. Do yours happen in any particular circumstances?

[Buffafly in reply to Buffafly]

I didn't really answer your first question, answer is that I could drive if the fainty episodes were caused by a heart irregularity fixed by the pacemaker.....

[Suzy1954 in reply to Buffafly]

I’m the same. They happen when I’m resting. Just have to wait and see now🙄. Like you say, nothing happens when you wear the monitor!

[Buffafly in reply to Suzy1954]

Keep us updated X

[Suzy1954 in reply to Buffafly]

👍

[Pearce1940oscar in reply to Buffafly]

I was having episodes of feeling faint and was also taking amitriptyline dr stopped me taking it and the faint feelings stopped wish I could still take it as it helped my nerve pain so I now am in pain every day so I’m just wondering if the fainting spells could be caused by any medication you could be taking

[Buffafly in reply to Pearce1940oscar]

Thanks for the suggestion but the only medication I am taking is the lowest dose of Diltiazem which could indeed be the culprit but I need to take it. Pain relief is another problem, I have been more or less told I have to learn to live with the pain.

[Suzy1954 in reply to Buffafly]

Sometimes you feel as though you’re between a rock and a hard place! Hope you can find something to ease your pain Buffafly.

[Suzy1954 in reply to Pearce1940oscar]

Sorry to hear that. Is there anything else you could take for the pain? I think my problem could be due to meds as everyone I’m on causes low blood pressure 🙄

[Gatun in reply to Buffafly]

I got off of Diltiazem and haven't passed out again. I never felt good taking that med but maybe that's just me.

[johnpb0]

Hi Suzy. I have been having palpitations and "feeling faint" issues for a few years. Doctors have never taken it seriously other than giving me more blood pressure medicines! In the past 18 months I have been having blackouts as well. I was finally sent to a cardiologist following a 24 hour monitor and echo. The ecg at last showed irregularities and I was diagnosed with Sick Sinus (brady/tachy) syndrome with pauses of up to 3.5 seconds and PAF. The pauses when I passed out must have been longer than 3.5 seconds. I was then booked for an urgent pacemaker, which I am having fitted on Friday. The Cardiologist told me to cut my 10mg Bisoprolol down to 5mg. After a couple of days the faintness disappeared and so far I haven't blacked out again.

My point is that Beta Blockers can apparently cause these events as well as cure them! If your problem is down to Beta Blockers I would ask your doctor if you can reduce the dose and see if that helps.

[Suzy1954 in reply to johnpb0]

Wow does that mean you wouldn’t really need the pacemaker now you are better on a low dose ? I’m already on a low dose (25mg) as it is of Atenolol and doc said I can’t stop taking the beta blockers because of my AF. I’ve never passed out yet but it seems I have to get worse before anything will be done. My cardiologist is very cautious so he likes to wait and see. It’s just a bit worrying. Good luck for Friday 👍

[johnpb0 in reply to Suzy1954]

I also wondered about the need for a pacemaker now but I've been offered one and I can't see any reason not to have it. It will regulate my lowest heart rate to a safe pace, which will hopefully avoid fainting fits and passing out again in the future. You never know what's coming next with these problems, but you are right that the problems have to get worse before they will intervene and it is all very stressful. I do hope your problems are sorted out soon and thanks for your good wishes for my pacemaker op on Friday.

[Buffafly in reply to johnpb0]

Best wishes. There is also the point that if you have a bad episode of fast AF I think there are more options for controlling it with meds. My cardiologist told me I can't use a double dose of Diltiazem or any other medication as PIP so if my heart goes too fast I have to have treatment in hospital and be closely monitored.

[Talika in reply to johnpb0]

Mine was caused by flecainade

[Suzy1954 in reply to Talika]

Goes to show it can be the medication!

[Flyer2820]

Hi Suzy1954

My wife has had a pacemaker fitted as her heart was stopping in the night. She has had a history of blacking out but doctors never got to the root cause. As someone else has said, when asked if she feels better now she says, " I didn't feel bad in the first place ". The pacemaker is working all the time but she doesn't have any knowledge of it and finds it of no inconvenience. The operation to insert it was not traumatic either. Hope this puts you mind at rest,

and all goes well for you.

Regards Flyer.

[Suzy1954 in reply to Flyer2820]

Thank you for that Flyer. It does help to put my mind at rest. I’ve had three open heart ops in the past so the fitting of a pm shouldn’t be too bad if I need one. It’s good to hear your wife is getting on well with it.

[quanglewangle]

Hi Suzy

There is clearly a group of AF sufferers like you and me that do not have the clearly worrying high HRs. Cardiac induced syncope (CIS) could be amplified by the beta blocker - especially if your resting HR is already low. A loop recorder will identify these stoppages and their length - as did mine - the medics are looking for evidence that your fainting is CIS and not vasovagal or postural syncope or (imaginary!)

Until you have a firm diagnosis avoid driving and take care crossing roads! The fainting is scary and the blackouts are worse.

Once a pacemaker is installed you will still have AF but the PM cuts in when your HR drops (60bpm in my case) - and I am totally unaware of this and was amazed at my annual checkup when I was told it was cutting in 25% of the time.

So watch what is going on and take care - but make sure that you get a Loop Recorder if the 24hr or longer Holter fails to catch one of these episodes - as they inevitably do.....

[Suzy1954 in reply to quanglewangle]

Thanks for that info. I haven’t actually fainted yet just feel light headed and a bit weird. Cardiologist is cautious about fitting loop recorder because of risk of infection ( I had endocarditis years ago) but his registrar said they’ve fitted thousands and never had a case of infection.

[DGET1]

I have got paroxysmal AF and when I get palpatations, I often notice a missed beat, but have never discussed it with a doctor. Think it’s probably ok when you’ve got AF.

[Rubyray]

I had my first AFIB episode in June 9,2017 Converted to normal rhythm the next day. I was in the hospital, under a lot of stress due to shingles on my face. Had second AFIB, 10/28/2018. Converted to normal rhythm 11/07/2018. Passed out when I converted. I was in AFIB on and off and on Feb 05, put on 30 day heart monitor. On Feb 27 went into AFIB. Passed out for 8.6 seconds. Fell in kitchen broke right ankle. Admitted to hospital had ankle put in cast for weeks, and had pacemaker installed on March 4. Ankle almost well, No more passing out. Was in AFIB about an hour one day after eating something with MSG in it. But I feel much better and I am happy the pacemaker works so well. Hope my story is helpful.

[Suzy1954 in reply to Rubyray]

Thanks Rubyray. That’s very helpful. You did go through the mill a bit before they sorted you out though! It’s good to hear you’re feeling a lot better 👍

[Jlaine]

Not at all. Loop recorder was offered right after my heart attack.which inadvertently caused ad in after stent insertion.

[Faraday954]

I’ve definitely noticed missed beats more often over the last year that I’ve been taking beta blockers, interesting to hear others thoughts about a link between the two. Mine tend to happen more at rest or if my heart rate drops into the 60s. I’ve captured a few on my Kardia but my doc doesn’t seem concerned. If you don’t have a Kardia, it might be a good investment for you. The more data we can give our doctors the better in my opinion. Hope you are feeling better soon!

[Suzy1954 in reply to Faraday954]

Thanks that sounds like a good idea. I nearly got a Kardia once but thought maybe I would get a bit obsessed with checking it. I might look at that again. Mine happen at rest as well. I’ve had ectopics for a long time but these pauses are a bit more disturbing.

[Faraday954 in reply to Suzy1954]

It is easy to be obsessive but I set guidelines for myself about when I will use it and it ends up being comforting when I’m having symptoms

[Jjda]

I was having that about 5 months ago. Feels like your heart just stops for a moment, then starts again. I went to the cardiologist, and he asked if I was drinking caffeine. I was, so I stopped and so did the skipped beats. Easy Peasy in my case, but they did put me on a 30 day monitor, which showed some extra beats, but no Afib or anything serious.

[Suzy1954 in reply to Jjda]

That’s good to hear it was something so simple and you are fine now. I hope that continues for you 👍

[Tux18]

I have a loop and have had a few three second pauses over the last couple of years. One Cardiologist wanted to put a pacemaker in ASAP. Then I went to another cardiologist and he said I did not need a pacemaker as it is not uncommon when going in and out of a fib to have pauses as long as they were not over four seconds he did not see need for pacemaker.

Due to frequently low pulse rate and pauses I cannot tolerate any blood pressure beta blockers or heart medications. The only medication I’m on is Xarelto

[Suzy1954 in reply to Tux18]

Oh right. I’m beginning to think it could be the beta blockers. I certainly wouldn’t want to jump straight into having a pacemaker without looking at other things first. Thanks.

[realdon]

My experience very similar to so many of these posts. Syncope caused by heart pauses was cured by pacemaker since when (over 6 years now) no more dizzy spells or faints.

One bonus is that the pacemaker records the number and duration of AF episodes which helps in assessing whether to go for an ablation.

[Suzy1954]

Hi. I wish I could have an ablation but because of scar tissue from previous heart ops they refuse to do it. I had 3 cardioversions 5 years ago 2 of which worked for 6 months then the last one worked for one week and they won’t do anymore.

[Suzy1954]

Yes an AVR and Mitral valve repair which caused a pseudo aneurism years later. The cardiologist has worried me about any further intervention 😳

[Suzy1954]

Really! So similar to me. Apart from what I said I’ve had, I’ve also got an aortic aneurysm that they’re keeping an eye on! I now go every two years as there has been no change in the size. I should have said, the Mitral valve repair was unsuccessful and they’ve talked about having another go one day 😳 🙈 i hope things remain stable with you 👍

[Suzy1954]

Are they going to do anything about the valves? Or is it watch and see.

[ETHEL103]

Yep suffering as I write. Got 14 day monitor on 2 Aug.

[Quilter43]

I have a loop recorder. I had a pause hours after booster COVID Dr says maybe stress heart but a vaccine cannot cause it.Just wonder about it all.