PAF for over two years, but now 'heart block'?

[momist]

Hi everyone. Some of you will know some of my history, but here's a recap:

I had my first AF occurrence back in May 2017, two and a half years ago. I was seen by an EP and put on his waiting list for ablation. In mid September 2018 I was offered an ablation at very short notice, and as I had no knowledge of the new EP involved and also had not had an event for about six months at that point, I declined. As a result, I was taken off the waiting list, although I wasn't actually told that. I was scheduled for a consultation 'in due course' which eventually came in June this year, and I was both put back on the waiting list (for the consultant EP) and also scheduled for investigation of the digestive problems I've been having, which appear to be linked to my AF occurrences.

Yesterday, I attended my GP for a follow up blood test/urine test relating to what the GI Physiologist had found, and happened to show her a Kardia ECG. She immediately said "that's not AF, it looks like a 2 - 1 heart block". She will refer me back to the EP for this.

I've looked up heart block, but I don't feel well informed on the matter. Does anyone here know what may be going on, or have suggestions for where to look next? Thanks for reading!

[BobD Volunteer]

I( would be cautious about jumping to conclusions. Kardia traces are good but I can't see how a GP could make that conclusion when a proper 12 lead ECG would be needed for most people especially if the kardia did not mention this. I know that it take a lot of training to understand a 12 lead ECG so unless your GP is a part time cardiology consultant I would wait and see what your EP says.

[momist in reply to BobD]

Thanks Bob, I can't disagree with anything you've said. However, I can positively say that this isn't AF, as the rhythm is very, very regular. It's just strange!

Mostly, it's two beats, pause, two beats, pause, etc. Sometimes though it's two beat, pause, one beat, pause, two beats, pause, one beat, pause, etc.

And this carries on for hours and hours. Typically, I wake at 5am with it and it continues throughout the day until maybe 11pm when I revert to NSR. It hasn't (yet) happened two days running, but can certainly happen on alternate days. While the rhythm is wrong in this way, I have the feeling of heartburn (but nothing found so far in my tests) and also palpitations. I'm very low in energy and can't manage hard physical work.

For over a month now, I've been working very hard. I've demolished a concrete garage and it's base, and filled three 8 ton skips with broken concrete and bricks. I had this strange beat a few times before starting the work, and it's happened again since, but luckily never while I was in the process of it! It's not the hard work that keeps it away though, as I was stopped from working on the project towards the end by the effects.

No doubt the EP will get to the bottom of it, but that might be weeks or months away.

[BobD Volunteer in reply to momist]

Sounds very like ectopic bigeminies. I once had ectopic multiples for about two weeks. They would be every second then third then fourth etc up to eleven and then start again at two three etc. and rock solid regular cycle. That was before I learned about the slow deep breathing exercise which usually works so well. VERY irritating when you are trying to go to sleep.

Well done on the concrete by the way.

[momist in reply to BobD]

Yes!! Looking at bigeminy on Wikipedia, there is a pattern labelled "simple ECG of a Supraventricular Bigeminy" which is almost exactly right for the most common pattern I have. Thanks Bob! Well done.

[BobD Volunteer in reply to momist]

Great, at least you know not to trust your GP's cardiac knowledge. I'm not even a medic!

[djmnet in reply to BobD]

Wow. I'd never heard of bigeminy before. BobD continues to educate us every day! I hope you know how important you are to us all!

[BobD Volunteer in reply to djmnet]

You can have trigeminy too.

[djmnet]

In a nutshell, GPs have very little knowledge about cardiology issues. I personally would not rely upon their "diagnosis" from a Kardia readout.

[momist in reply to djmnet]

I never regarded this as a diagnosis, but was happy to have another referral back to my EP.

[bonnie54]

Hi, had so many side effects with Sotalol the cardio gave me Flecainide, but after 2 weeks of feeling housebound went to see cardio urgently and he found the Flec had given me heart block. Straight back to Sotalol needless to say. A successful ablation the following year gave me my life back, and that was 10 years ago now. There is hope and life after AF. Good luck with your AF management.

[momist]

Thanks bonnie54 . The weekend got in the way, and I'm away for the next two weeks (if it goes to plans). We'll see how I get on.

[Hidden]

One thing you could do would be to send the Kardia EKG off to them for analysis- this would be for confirmatory purposes. The analysis can identify heart block and bigeminy.

[momist in reply to Hidden]

Hidden , I see you too can be confused about this forum. I found myself this morning reading a post from three years ago, for some reason probably to do with an update of my mail reader software.

The bigeminy, thankfully, stopped happening after about three months of it, some time last year. I seem to have now gone into a spell of remission, perhaps due to the lock down ground hog day effect. I do so little now except sit and knit, read and watch TV, with a single 40 minute walk most days. Also, I rarely drink alcohol any more, and find when I do I feel a bit unwell.