8months post first ablation and ? slow AF episode

[Di8504]

Hi everyone

I am always interested to read other people’s experiences living with AF. We certainly have many variations in how the ectopic rhythms play out with different external and internal influences muddying the pool of symptoms and how we deal with it.

I am nearly 8 months post my first PVI when my EP also shut down some SVC triggers.

I am only now attempting to come off my drug combo (due to early AF episodes then multiple ectopics) which was verapamil, digoxin and flecainide. My resting heart rate is still 15-20 bpm above my preablation level which my EP says is not normal at this time after the ablation.

Before reducing the drugs, they mainly controlled the AF but still left me with some atrial ectopics and poor energy levels as my exercising HR was limited. So I feel more energetic now.

My current dose of flecainide is tiny- 50mg each evening. 2 nights ago I had a run of AF (kardia) when I lay down in bed with pulse varying from only 55-80 bpm. Getting up after 40 minutes Of it, and walking around, then deep breathing , seemed to trigger it to settle down and Kardia saying NSR so back to bed and 2 hours later still SR. I have had usual post AF heavy chest and tiredness since.

I am reluctant to increase my meds againand felt Flecainide would have just lowered my HR more so held off taking PIP at time of event.

My EP previously blamed my short episodes of palpitations on atrial ectopics saying they couldn’t do another ablation unless they can trigger actual AF.

Do many others get slow AF? I could understand it I was still on beta blockers or Calcium channel blockers. Or can atrial ectopic rhythms be so irregular to feel like aF and read as such on the Kardia 1 lead monitors.

Sorry to be so verbose.

Best wishes to all

Di

Australia

[CDreamer]

I get slow AF now, never used to. Post 2 ablations & Pacemaker. HR in Af was always 150+ and now 70-120.

I take no heart meds.

[Di8504 in reply to CDreamer]

Thanks for that reassurance!

[Goosebumps]

Hi. Like you I am slow AFib, HR rarely goes over 100. I'm persistent however, symptoms like you are the heavy chest and extreme tiredness. I'm occasionally dizzy as well when HR falls below 60. so I'm bearing with these symptoms every day now while I tread the slow path to intervention under our NHS system.

Only medication for me at the moment is Apixaban, I've steered clear of beta blockers until cardiologists can convince me that lowering my HR is a good thing and only after further tests show whether I have other complications.

I've only corresponded with one other person on this site with slow AFib and they reported the heavy chest symptom as well. We seem to be quite rare on here. I don't get palpitations or breathlessness at all.

Hope this helps.

[Di8504 in reply to Goosebumps]

Thanks for your feedback. Hopefully the AF and ectopics will stay manageable - otherwise my EP will hopefully advise more ablation. Fortunately my EP is only 10 minutes away at an excellent hospital -

[Padayn01 in reply to Goosebumps]

Hi Goosebumps365, may i ask why you stayed away from Beta Blockers have you been on them before? thanks

[Goosebumps in reply to Padayn01]

I've seen three cardiologists, even before I've had a 24hr Holter, so they were all guessing about my heart rate. One said don't do Bisoprolol unless you find it really helps, another didn't mention it and the third couldn't understand why I wasn't taking it. Talk about confusion.

But I am a slow rate persistent AFibber..

I've got an HR monitor and I rarely go above 110, usually in the low 70's, so why do I need to bring it down? Never had a problem with BP either.

I haven't been on beta blockers before,

I've just done the Holter this week, no results yet, due for nuclear perfusion scan next week. After that I'll sit down with the NHS cardiologist and probably take a second opinion from a private one. Then I'll make the decision on whether any beta blocker is right for me if it's recommended. But so many people on here have issues with Bisoprolol I think I will take some convincing to go with that one.

Also, the fewer med's you take the clearer your symptoms are...

Sorry it's such a long reply.....

[Padayn01 in reply to Goosebumps]

No not at all brilliant reply, when I was diagnosed with AF they put me on bisraprol had a bit of a hard time with it than they put me on metraprole which was better

[Di8504]

Btw I also have variable blurred and double

vision issues for past 12 months with PAF. I was blaming the flecainide but my current dose is tiny. Optometrist says no local cause in eye and must be in visual cortex etc. Weird

[Goosebumps in reply to Di8504]

Me again. I've had those symptoms as well , before I went onto Apixaban and I'm not on Flecainide. They have improved over time. I had my eyes checked as well, nothing wrong, so I think your Optometrist may be right.

[Bob56]

My AF has always been slow. My resting heartbeat is around 60, and my AF rarely goes above 80/85. It is just an erratic mix between fast and slow beats, and can sometimes be quite similar to ectopics, the difference being that ectopics miss the beat on a steady basis with normal beats in between. The AF has a mind of its own and can be any combination! ( I liken it to the tapping out on a morse code machine)

I think Flecainide works well on slow AF, but beta blockers can be a different story. I take Bisoprolol, and in the middle of the night my heartbeat can get down into the 40s without much encouragement. The problem is that you take medication to treat one thing, but can then pick up unwanted side effects.

When I did use a Kardia readout, my machine usually got it right with AF but generally came back unclassified if I had ectopics. I had an ablation nearly 5 years ago which has helped a lot with AF, but has not alleviated the ectopics.

[Di8504 in reply to Bob56]

Thanks Bob

The Kardia does seem to be conservatively accurate for AF. I still hope my resting HR will drop back to its pre ablation rate without needing drugs.