To give a little medical history first, I was born 2 months early and had a murmur that never closed up. Until I was injured at work at the age of 36 and had to take a lot of pain killers etc I never had any heart problems. Age 39 I had an ASD surgery to have the hole closed up. Again I was good till about age 46 or so. I start to get the rapid heart pounding in the afternoon after I have had my shower and ate, at this time of afternoon 5 pm to about 10 pm I'm mostly on the couch watching tv and crocheting. I have had 3 Ablations and 4 Cardioversion in the past year. My last Cardioversion was May, the last ablation was March of this year. This last hospital visit I was started on Flacsinide, which has made me gain about 8 lbs in about 3 weeks. As of Friday, I am off of that and now back on metoprolol. So far I'm still having a high heart rate in the afternoon when I'm resting.
The doctor is now talking about the possibility of a pacemaker. Not sure how this would help with a fast heartbeat. Does anyone here have this problem or had this happen to help.
Written by
rock1038
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Hi - I had a PM inserted late 2018 and worked for me, only one or two episodes since and those when I had a bad viral infection. I had very symptomatic AF for 12 years which had put me into the acute cardiac ward after ablation No1 in 2013. No2 worked for some 3 years and when AF returned it was less symptomatic but when I started having 3-4 episodes a week, enough was enough and my options were Amiodarone, no thank you, or Pace & Ablate. My HR would usually be in the 160-190 area when in AF and I couldn’t tolerate any rate reducing meds but my EP was not so concerned about the high HR but I started to go very low and then very high. I also had a hole in the atrial septum, only discovered during Ablation No1 but not repaired as it wasn’t thought to be causing any symptoms or was leaking blood.
I went for Pace and Ablate and was advised to have re-synchronisation therapy PM and it was amazing as from day 1 of insertion I began to feel much better. I had to have a revision & repositioning of the LV wire in June 2019 and since then things have just continued to improve heart wise. My sats are up, no more near syncope, more energy etc. My heart behaved so well that I couldn’t see that AV node ablation would help me so I then refused the planned procedure, but am keeping it in mind if my arrythmias return.
It’s really difficult to comment simply because everyone’s decision is so personal so I can only offer anecdotal experience. Some people are able to tolerate Af without intervention and your HR is not that high, normal would be in the 60-120 range but it does depend upon how symptomatic you are? Some people would find a HR of 100 high whilst I don’t feel or notice it until it goes 130+.
Pace and Ablate is the last resort measure for very symptomatic AF, it will not stop the AF but it paces the ventricles so your pulse remains steady and therefore removes the symptoms. You don’t say how symptomatic your AF is? As treatment for AF is to improve quality of life I would consider how your AF affects you and if you are not that symptomatic, ask your doctor as to what the prognosis of living with AF as is would be?
Just one comment - my AF often started after eating so I changed what, how I ate. Carbs were the worst antagonist so I cut bread, cake, potatoes etc. Your automatic nervous system needs to be in Rest and Digest mode to affectively digest your meal - most animals go to rest after eating. If you had a hot shower, then ate that could well have been enough of a stimulation for the vagal nerve to trigger AF. I always finish a shower with cold water, this can be incredibly affective in calming Vagus nerve. I alternate warm/cold water for 20 seconds each. I now hate hot showers as they make me feel so drained whereas I feel invigorated after cool shower.
What and how much you eat will also influence your heart rate so taking time over your meal and eating at table, resting and then a short walk all help your digestion, therefore minimising the trigger for an episode.
I have the afib episodes constant every day from around 4pm till some times after midnight. I normally go to bed around 10pm. so getting good rest is hard. My HR goes from around 70 up to 120 to 130.
I have a pacemaker and I have Afib. The pacemaker does not stop AFib! I had to have a pacemaker because the medications I have to take can stop my heart. Be carefuk
I am certain I have vagal paroxysmal AFIB. For that reason I am not able to tolerate any beta blockers. Beta blockers (Bisoprolol) made me very ill - and it made my Afib a lot worse. Calcium blocker was as bad for me. The only medication helped was Flecainide. I take it only on as needed basis.
It sounds you too have a vagal AFIB. I suggest you look into that possibility. Unfortunately doctors in North America do not recognize Vagal mediated Afib.
Dr. Richard Bogle (cardiologist) says: "When to suspect vagal AF: If the arrhythmia occurs at rest, after meals or during sleep then it is more likely to be vagal stimulated... Please read his articles - see link below.
How long since your 3rd ablation? It took 6 months after my 3 one to get back in rhythm. If this doesn’t work try a 4th ablation. pace maker very last resort!
My last abation was in March of 2020, Before that December 2019 and October 2019. Since the last ablation I was hospitalized and had to have an emgerance cardioversion last month.
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