48 hour monitor - heart rate peaks 170 bpm

[Reena09]

I previously mentioned that I had a recent 48 hour monitor and the findings confirmed I was in AF for 30% of the time. I have no real symptoms other than finding it more tiring walking up inclines in the heat. My cardiologist has referred me to an EP to discuss an ablation but I am not that keen. I’m 71 and was diagnosed 2 years ago with PAF. However, the results of the monitor show my heart rate peaked at 170 bpm. I am

only on 1.25 mg bisoprolol as resting pulse was too low with 2.5mg. My cardiologist does not seem concerned with the heart beat at this level - should I question this? I am also taking apixaban, Simvastatin and have underactive thyroid. Thank you for your help

[CDreamer]

I had similar high HR - up to 200 - and my EP wasn’t concerned either. I found ask a GP and they don’t seem to like high HR but I questioned my EP very thoroughly and he said that a high HR will make no difference but the irregular rhythm will over time so they would always prefer to have you back in NSR. I am unable to take any rate or rhythm control drugs at all. The problem with increasing the beta blocker is they will reduce your HR all the time and that can make you feel uncomfortable, I certainly was unable to tolerate them but some seem to find them helpful.

Treatments for AF are really for symptom control so if you are not that symptomatic and fit and active and not overweight or have other lifestyle AF influencing factors, I can understand your reluctance, however, it may be worth having the conversation and finding out more as the sooner AF is treated with ablation the higher the success rate and if the AF is becoming more frequent then you may very well find that your QOL declines accordingly.

[Terjo]

The question of having an ablation is one that I am not so sure about but I take bisoprolol now after years of resisting it. I was very poorly with a very low pulse- 29 - 30 beats per minute so was fitted with a pace maker. This device has changed my life for the better and I am able to do things this last year that I found impossible to do before. I take 2.5mg of bisoprolol in the morning after breakfast and another last thing at night, I also take digoxin and half a water tablet together with sodium,vit D and vit B 12 in the morning. I was treated for 10 years by an extremely good doctor who has now retired as also has the consultant whom I saw at the hospital. My GP now is a surgery where one is treated by a nurse. I see the person who phones me about my warfarin occasionally. My age is 87 and I look forward to each day, they pass far too quickly now.