My wife woke up with her chest feeling strange.
I took her BP but it differed but on the low side. It showed a pulse of 120 to 150. Normal for her is 65.
Her wrist pulse is difficult to count as it is very fast then misses a few beats and then is normal for a few seconds before shooting higher.
I have SVT or AVNRT so am not too familiar with AFib.
How irregular is the AFib pulse? Does it go from normal to very fast in seconds and have missed beats?
AF is such a mongrel condition one realy cannot state one way or another. Generally it is so chaotic as not to be any kind of rhythm best desribed as a bag of worms.
Sounds like atrial tachycardia with ectopics but apparently even Kardia can’t tell the difference ☺️
This is very helpful for me... and may be my situation too - atrial tachycardia with ectopics. Because that description better fits what I am experiencing when I am arrhythmic (including right now). I had recalled hospital ER identifying this as afib back in May when they last hooked me up to ECG. But it could be that really was afib then, and my more recent arrhythmias (which involve rapid but countable heartbeat with some pauses and gaps and then muffled clumps of little beats) are what you say - atrial tachycardia with ectopics. It certainly doesn't feel like the uncountable "bag of worms" I thought afib was supposed to be.
I have no way of getting hooked up to ECG without another trip to ER, which is exhausting and unpleasant and never productive (except for the ECG) and takes many hours of covid exposure risk, and is basically not something I will do unless life on the line (which it isn't right now).
Why can't Kardia tell difference between afib and atrial tachycardia with ectopics, I wonder? (not that i have a kardia, but still curious about that.)
Kardia doesn’t identify ectopics . If you were in sinus rhythm with ectopics it would read normal or in some circumstances if they were very frequent unclassifiable. Any speed over 100 it identifies as tachycardia. It also reads possible AF if it thinks it is AF but apparently usually right but my consultant said the reading I had was atrial tachycardia with ectopics . It isn’t sophisticated enough to make finer distinctions . I don’t know if the new six lead one can . Unfortunately like palpman you can’t tell what you have with certainty without an ecg . My fathers AF was as you describe and very different to the episode I had. Hope that helps
Thank you Peony! That's helpful. So Afib can in fact feel like a countable tachycardia (countable with stethoscope), but with some irregular beats? And that pattern could also be atrial tachycardia with ectopics? And only ECG can tell difference? Is that right?
I am going to ask if my GPs office has an ECG machine. The ER experience really is unpleasant and very prolonged. Hours and hours just to get the ECG.
A cardiologist may be able to tell the difference from a pulse but as I understand it would always confirm with an ecg
Thank you! This helps me know how to try to sort this out! 
Have a look on the Kardia website for their ECG training course (free online examples etc.). You might be able to interpret your own records, somewhat.
That's a good idea - looking online so I can learn a few things about the ECG and how it is interpreted.
I would say that my afib felt like my heart was trying to jump out of my chest. The atrial beats are chaotic while the Ventricle tries to keep up. Mine clocked in at 140bpm when I went to the emergency room. I also felt nauseous and lethargic. Not a condition I would like to spend a long time in.
Kardia also doesn't recognise bigeminy. I have been through a longish period of getting bigeminy after every meal, which in extreme cases then led on to full AF. Luckily, this seems to have quietened down now, although I still have short periods quite often immediately after eating. I have avoided having this investigated, due to the covid issue. Once we have enough people vaccinated, maybe we can all return to a normal medical service, but this seems months away yet, and the worst is still to come.
I am not familiar with bigeminy. Am going to look it up. Yes, Covid has really affected medical care (and even dental care) in so many ways beyond Covid.
I ve only had one episode of AF . HR was 170 and basically going too fast to count or notice any irregularity . Your wife could have had atrial tachycardia with ectopics. I doubt you will be able to get a satisfactory diagnosis in retrospect . My understanding is sinus doesn’t go above 140. ( obviously I am not a doctor) . How long did it last ? Have you got a Kardia device you need to catch it to know . In bisoprolol withdrawal I was going from sinus tachycardia to atrial and SVT . according to my cardio looking at the Kardia print outs Hate that drug. Hope your wife is ok
Thanks for the replies. I read them all to my wife and she now feels less anxious.She now has had it for 10 hours but will not go to the GP as her GP is not very clued up on arrhythmias.
I think you should go to a&e 10 hours is quite long enough and what a great opportunity to get it on tape . Ring 111 they book you into a&e and you are fast tracked . She could try the val salva manoeuvre and tricks you will know about with your condition but I would ring 111 and go to the hospital
Peony what is this maneuver you are referring too please?
You should ask your doctor about it as there are some people it is not suitable for and it is wise to check before trying anything like that . You can of course get information from google or u tube. But if you have a pre existing heart condition you should check with your doctor before having a go
She has tried all the manoeuvres I am familiar with to no avail. She refuses to go to A&E at this stage of the pandemic and I myself would not.And, no. I don't have a Kardia as we are pensioners from South Africa and the Rand is far to weak at this stage.
I think her AFib started when she saw our pension payment in the bank
Has your GP practice got an ECG machine ? Ring them up and take her in there as an alternative . Ring 111 anyway they may send an ambulance who would do an ECG on the spot . 10 hours is a long time and if it is AF she would need anti coagulating because of the stroke risk. You really do need to know what it is . I had to go into a&e with my episode at the height of the pandemic and emerged unscathed I would rather risk Covid than a stroke . Please keep us posted as to her progress
Hi, in SA or here but from SA? I am South African but thank goodness do not have to rely on a South African pension. Wherever, I do think your wife should checked out as this is new to her, best wishes 💜
We are from Cape Town and have been here for 18 months. I had no idea that you were also from SA.
Buffafly, why was I convinced you were from Northern Ireland!
No idea! I live in Somerset 😀
If your wife has Atrial fibrillation, and is seen and diagnosed within 24 hours of onset, she may be suitable for cardioversion, by drugs or electric shock. If it is more than 24 hours she would need weeks of anticoagulant before cardioversion.
When my arrhythmia fits the description you gave for your wife's - rapid but quasi-regular heart beat with skipped beats, pauses, doubled up beats... not countable at wrist but still countable on stethoscope (my main tool at home)... If I go to ER in that situation and get hooked up to ECG, it says afib. Every time. So afib is not always the uncountable "bag of worms" that it can be for some. I don't really understand this myself because it seems to me that afib, by definition, should always be am uncountable bag of worms. But mine is not.
Also, another good indicator for me in trying to distinguish between NSR with ecotopics, vs actual afib is: If I can count 100-120 bpm with the stethoscope on heart, but pulse oximeter on fingertip only counts 40-60 bpm and the waveform on the pulse oximeter is a flat line with a few blips in it rather than proper NSR pattern with good peaks and troughs... then that's afib - when the pulse-oximeter reads a heart rate 50% lower than stethoscope, and the traveling waveform on it looks terrible.
Useful to invest in good quality stethoscope and pulse oximeter for home use and monitoring.
Amending my comment above to say: I don't really know for sure if I am experiencing Afib or atrial tachycardia with ectopics, now that a couple other members here have remarked that the latter is also a possibility. I would need to get hooked up to an ECG again to know for sure, and do not want to endure the multi-hour ordeal of Nanaimo ER just to get an ECG reading.
I think the initial diagnosis in A&E is automatic the same as Kardia because the nurse tells you straight away that it’s AF. My cardiologist didn’t agree with the AF diagnosis on a later ECG, he thought it was Atrial tachycardia. Reading ECGs is very difficult!
Good to know. Thank you! I didn't realize reading ECG was that difficult, or that a determination of AF on an ECG actually might not be AF. I need to somehow investigate this more fully.
Yep, reading an ECG is a skill that needs proper teaching, and is too involved (I gather) for GPs and nurses to get deep into. In my experience, even cardiologists can be dismissive and flippant about arrhythmias, and it needs an EP to know just what is happening.
I wonder where I should start? Should I get printouts of my past 2 ECGs from ER... that may not have even been correctly interpreted at the time? And then find an EP somewhere to review them? I don't think we have an actual EP in Nanaimo, so would have to send it out of town and I guess have a phone appointment.
I cannot figure out how to get a current ECG while I am arrhythmic, without submitting to 6 hours or more in ER, where they want to "treat" me and not let me go until they have successfully "treated" me, which I don't want from them. Their "treatment" is always either ineffective or not appropriate. I end up battling them for hours then slipping away unnoticed when all I want is an ECG to document what heart is doing in a period of arrhythmia so that someone else can interpret it correctly.
So sorry if I upset you. I was giving my honest opinion, and perhaps trying to say that not all doctors are perfect. I do respect the long, intensive and comprehensive training they must go through, but no longer hold them in awe, or accept everything they say as gospel.
EDIT: I just googled where you are. WOW! My imagination is fired up, it must be a fantastic place to live, other than the medical aspects. Maybe an EP in Vancouver?
I'm not upset at all. It's just been and continues to be very frustrating for me to figure out how to move forward on getting the information I need about my arrhythmia.
I am never going to be a patient who simply goes to the doctor and takes whatever pills she is handed - for anything.
And so since I am self-treating, I need to somehow figure out if this is really afib, or "just" atrial ectopic tachycardia, or something else altogether. I shall keep trying.
Yes, Vancouver or Victoria (here on Vancouver Island) would be where we would have our nearest EP, I think. Very nice here. No snow yet.
kim
Thanks for the good info. She has reverted back to NSR an hour ago and will cut out on Christmas sugary eats that may have been the culprit.
Very happy to hear your wife self-converted!
Very interesting. Thanks for posting.
Whatever it is, she will do well to get an assessment. For me it took quite awhile to "catch" an episode for the docs to evaluate. ECGs are just a "point in time" so if the episode isn't happening the docs cant evaluate it. The best device for me was the kardia, so I could catch it and show the doc. Then I had to have a two week holter for them to get a real picture of what was going on because my heart decided to behave whenever I had a five day holter. Hope this helps. I am feeling great and able to sleep without the crazy heartbeats now since I am 3 weeks post ablation.
I am newly diagnosed (July 2020) and struggling to get the afib/flutter under control. With flecainide I was getting weekly episodes which were lasting 48 hours, now I'm on sotalol, it seems ok although sometimes I feel my heart 'wobbly' nearly always when I am lying down. I have been quoted a success rate of 80% by my EP for ablation at first procedure, would you recommend I go for it? Did you struggle with your afib before ablation? Thanks..Karen
Yes it does, this is just how mine behaves
Mine varies up and down. I am most of the time in A Fib. I take a med to slow my heart and a blood thinner. This summer I wore a monitor and my average heart beat was 100 to high thus the Meds. I never know if I am in A fib
I have "fast AFib,." Mine always beats in clusters of "fast" and then skips. Completely erratic. I can't begin to count them but I have a pulse oximeter which gives me some idea. But I'm not confident that it picks them up either since sometimes it stays around 60 when otherwise it's around 120-150. At other times the bar stays level as if I have no beats at all. What a mixed bag. My BP monitor, although it's supposed to measure AF, doesn't do HR accurately either. I would like to know what my actual HR is at those times but I suppose it wouldn't make any difference anyway.
Yes. Exactly like that.
Permanent AFib
Still irregular pulse
Can you tell me what is this new symptom?
Afib brought on by steed 
Palpitations getting worse, is Afib likely?
