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Sinus Tachycardia following Paroxysmal AFib episode

FizzioGirl profile image
20 Replies

Hello All. This is my first post although I have been a 'voyeur' of this forum for a few months now so, thank you for all the AFib information I have gleaned! It really is a great resource. I'll try and keep my back story short...I am a (almost) 51 year old female form the UK and had my first paroxysmal AFib episode about 2 and a half years ago. Very scary - did the whole A&E thing but typically the episode had passed and I was back in NSR by the time I got hooked up to an ECG. Couple of similar episodes over the first year (usually induced by a short burst of exercise) but few and far between and lasted no more than 2-3 hours before spontaneous reversion to NSR. Eventually managed to catch one on ECG which confirmed fast AFib (160-180bpm). I asked my GP to be referred to an EP and I am under the guys at the JRH in Oxford. The second year I had a couple more scary episodes but not necessarily with exercise - just 'out of the blue'. Have been tried on Bisoprolol and Diltiazem neither of which made any difference to the frequency or intensity of my episodes. Just before xmas 2019 my symptoms went to a different level. Had an AFib episode on 23rd Dec which settled as usual after an hour or so but left me in sinus tachycardia with a heart rate of around 130 which didn't settle. Off to A&E again where they tried IV betablockers, IV digoxin and eventually IV amiodorone. Nothing brought my heart rate down and the amiodorone seemed to kick me back into AFib. I was put on apixaban, spent xmas day on a trolley and was electrically cardioverted 10 days late!. Back in NSR for 10 days then exactly the same pattern happened - started with AFib episode, then tachy (actually admitted onto cardio ward this time) tried all the drugs for a week then cardioversion!! Third episode followed the same pattern but spontaneously converted to NSR that time after 8 hours. Fourth episode happened last night with AFib which has now settled to tachycardia at 125bpm (so says my Kardia). The interesting thing with this is that these last four episodes have all been exactly 4 weeks apart (give or take a day) and at exactly the same point in my cycle (sorry boys, a 'period' reference there!). My husband will freely confirm that I am menopausal(!) and I wondered if anyone else has experienced this pattern? I made this connection retrospectively to begin with so have not been 'waiting' for an episode! So as not to leave the lads out, my second question is, has anyone else had this pattern of AFib settling into persistent (and drug resistant) sinus tachycardia? I have just received an appointment for an ablation on 7th April but I am not holding my breath as I suspect the pesky C-virus may have an impact on non-urgent procedures. I am sitting this tachy out at the moment but may have to present to A&E and see if they will do a cardioversion straight away as I don't see the point of being pumped full of drugs for a week that don't work for me. I am symptomatic with my tachy in that I am aware of my thumping heart rate and feel sluggish and not very useful. It goes even higher with the slightest exertion. So that's me! Sorry - bit long but thought a bit of back story would be useful. I'm quite excited to be a proper part of the 'gang' now!!

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FizzioGirl
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20 Replies
BobD profile image
BobDVolunteer

First of all I do know from some other ladies that hormones often trigger AF.

Secondly the rate you quote for sinus tachcardia may actually be atrial tachycardia as this is frequently a side effect of AF. It is easily seen on an ECG if you know what to look for (I dont!)

Glad you feel able to share you story now and hope the ablation goes ahead.

FizzioGirl profile image
FizzioGirl in reply toBobD

Thanks BobD for such a speedy reply! I'm hoping it is an SVT as presumably this can also be worked on during the ablation? In A&E they can't seem to work out if its flutter or SVT or just sinus tachycardia ( not that I'm sure what the difference between all these is!) My EP has only seen a kardia printout which I don't think is detailed enough.

CDreamer profile image
CDreamer in reply toFizzioGirl

Flutter shows up as a saw tooth pattern & is a regular irregularity. Unlike AF which as an irregular pattern.

Let’s hope your ECG is passed through to someone who CAN read them correctly very soon.

All I can say is I was far more symptomatic with Flutter than anything else - SVT or AF.

Good luck with your EP appointment & hope you feel better soon.

I can’t comment on hormonal monthly cycle as I was way past menopause way before AF BUT I have sleep problems every month - 2-3 days before full moon which often used to trigger AF episodes.

FizzioGirl profile image
FizzioGirl in reply toCDreamer

Thank you for your reply. I think I have a bit of everything AF/Flutter and SVT! Lucky me!! The only thing the A&E docs agree on is the AF. They 'um' and 'ahh' about my other rhythms! Anyway, I've just been sitting watching Boris and friends updating on C-virus and I've flicked back into NSR!! Fingers crossed it holds now until ablation. Thanks

CDreamer profile image
CDreamer in reply toFizzioGirl

Such a relief for you, hope it continues.

The craic on our family WA this evening was about the video clip circulating from the original series of Yes Minister - What are we going to do about it? -

Our grandchildren have are far too young to have seen them other than on YouTube but they think it the funniest thing ever and look forward to the proposed remake - we think PM character should be JB - Joris Benson - played by James Corden. Now who would we suggest for Sir Humphrey?

Jalia profile image
Jalia

I can sympathise with you as some of my very many episodes over many years have followed this pattern.

I recently had a 7 week episode starting in mid Dec with continuous tachycardia...115/130+....interspersed with very fast AF. I eventually had dc cardioversion which got me back to 68bpm. I am back on the waiting list for ablation no 4.

When I was first diagnosed at age 48 I noticed that my episodes ( which all required admission at that time and usually dccv ) were at about the same time in my monthly cycle. I was told that it was probably because I was more vulnerable at that time.

I am also refractory to most drug treatments.

Good luck with your ablation!

FizzioGirl profile image
FizzioGirl in reply toJalia

Thank you. I'm trying to do a bit of research on the hormonal link but can't find very much out there. Hoping I might grow out if it! Good luck with ablation no 4!

Jalia profile image
Jalia in reply toFizzioGirl

I'm sure you will grow out of it.... not much you can do really( the hormonal link) ! Can't grow out of AF though...it has ways and means 🙄

FizzioGirl profile image
FizzioGirl in reply toJalia

Thank you. Hope you are still feeling ok. 7 weeks in tachycardia is awful. 7 days was bad enough! Take care.

I see that someone else has suggested flutter.

I know that I had an uncontrollable HR.

Mine was 140 BPM when on digoxin and 12.5 mg bisoprolol a day

I spent 10 days on a cardio ward without them being able to slow me down. I had to wait 3 months for a cardioversion and first zap took my HR down to 55 BPM.

I was in AF though , but a nurse spotted on another occasion that flutter was kicking off my AF.

I had a successful ablation for fib and flutter, but do have svt now and again.

Less than 30 seconds but HR of 240 BPM +

FizzioGirl profile image
FizzioGirl in reply to

Thanks. It's reassuring to hear that others a 'drug resistant'. I thought it was just me! 10mg of bisoprolol doesn't touch my HR - just leaves me feeling like a zombie! Maybe it's because we gave great metabolisms???! Sorry you had to wait so long for DCCV but glad it worked.

in reply toFizzioGirl

The long wait was because my GP mistook AF for asthma 🙄 I was in AF for 3 months before diagnosis.

Good luck with your AF journey, and just as a FYI my wife is menopausal and had horrible palpitations but not AF .so it certainly could be a link

cuore profile image
cuore in reply to

Wow! You waited three months in persistent. Was that your first cardioversion?

Valsha profile image
Valsha

There does seem to be a hormonal link, as I was reading just last night!

healthline.com/health/atria...

Good luck with the trials and tribulations of AF. It’s a bumpy ride!

FizzioGirl profile image
FizzioGirl in reply toValsha

Thank you. Yes the link to hormones seems well documented but not much about what we can do to help ourselves. Its a complicated area I think.

Renj profile image
Renj

Yes that happens to me this past year.

lixaian profile image
lixaian

Hi FizzioGirl. sorry to hear about your medical kaleidoscope of problems. [long story] With in my job many of my residents are on lots of medications, in one case a resident was on 17 different medication and for two years she had not been out of her flat on her own due to being so ill and frail. One Friday she visited her Doctor who prescribed paracetamol for her head ache. on the Saturday of that week I went into my office to catch up with some work and noticed she had not booked in on our call system. I decided to visit her to say Hi and there was no response to my knocks, I looked through the letter box and saw her feet sticking out from the kitchen. I immediately called 999 and her daughter. The paramedics said she had over dosed on paracetamol, her daughters said no cos the pill dispenser showed she had taken the correct dosage. On investigation the residents daughter found that within her mothers 17 medications that many contained paracetamol. Her daughters took her off all medication less for 4 that were for heart probs. 3 months later this lady was a different person, doing her own cleaning and walking into town and she lost her frail look. The point bio=of this saga is ton shown that we all need to challenge our Doctors about any medication they give to us and constantly ask " Why". I was put on Apixaban some time ago and it made me seriously ill and put me in a lot of pain and my heart rate went up to 70ppm when normally it is 45 to 48. [I Train a lot] note to remember or research. The Pharmaceutical industry give Doctors back handers for each prescription they write and from my research it appears that most Doctors can receive upwards of £90,000 a year! last trip : Keep training but listen to your body, and challenge each medication your are prescribed because Doctors while they may know what medication can do they do not know what the cocktail of medicine can do and do not Annalise the affects of such a cocktail of drugs. You sound quite switched on so I am sure you will be well. and Smile.

lixaian profile image
lixaian

Hi Fizzio girl, Sorry about my poorly written last post, must read before posting in future, a case of fast fingers soory

FizzioGirl profile image
FizzioGirl in reply tolixaian

Lol! I get into all sorts of trouble trying to write messages on my phone! They are just not made for human sized fingers!! Thank you for your reply. I am a physiotherapist (the clue's in the name!) so have a little bit of knowledge but the key for me is really getting to know your own body and read around your particular ailment! Also have the confidence to realise that doctors are not gods and sometimes need to be challenged with the right well-informed questions - especially where medication is concerned (as your story shows). It's about taking control but also listening to the right advice. I'm off all drugs at the moment except Apixaban which I realise is vitally important for AFibbers. I seem to be ok on it except went skiing in Feb and didn't ski due to possible consequences which was not much fun :(

lixaian profile image
lixaian

GOSH Fizzio Girl, mmmm skiing my favourite sport, My Wife and I were

lucky enough to spend 3 years teaching skiing, I taught combat skiing and my wife a Basi level 2 instructor taught service families to ski in Bavaria.

For our leisure skiing we mainly went to Otz in Austria, indeed we did this for 17 years. Heaven.

I would get home on Fridays look at the snow reports and if favourable drive down to Otz with my wife and children just up the valley from Solden. Any way see my first blog on this site in which I mention Apixaban and that awful poison Quinine Sulphate which has ruined my life. That said, I am doing well and still, when I get any pain I train harder. The side affects of Apixaban were bad so now on Adexaban for the rest of my life. I suffer slight dizzy spells from it that last a micro second and my fingers tingle but other than that I am ok. This site is a mine of information with great members who have far greater knowledge than me. Keep well.

a quick tip. To keep a flat stomach each time I boiled the kettle, at the corner of the work top I lift my body up and do 40 stomach crunches which is about the time it takes for the kettle to boil.

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