New to this board - I have AF with Bradycardia and would like to know if bradycardia can be resolved if AF is stopped

[Frsmith]

I had an AF episode on October 31 and did not know what it was. I felt horrible. November 2 my heart dropped to 32 bpm. My wife took me to the ER immediately. 3 hours later I had a pace maker. I kept having episodes of AF and went back in for another heart cath. My cardiologist decided to set me up with an EP. December 11 he did a cryo heart ablation. I am struggling with my recovery, getting AF off and on. Never seems to last more than a few minutes to a day. After my ablation resting bpm was 105. It has slowly dropped to 80. Normal for me is 75, so I'm ok with that. Now to my main question - if AF is stopped or controlled, will I ever recover from bradycardia? The reason it's so important to me is my LV will eventually succumb to to congestive heart failure if it remains a couple milliseconds out of sync with the RV, which is being paced. My EP says Medicare will cover a bi-ventricle pace maker when chf reaches 35% (1 yr approx) and since my heart is otherwise strong it will fully recover. I would like to know if RV can ever pace on its own. Thoughts?

[BobD Volunteer]

Look at this fact sheet on recovery from ablation, heartrhythmalliance.org/res... which will doubtless help in your recovery.

I'm not medically trained but I would struggle to understand how Bradycardia is as a result of the A F. Although slow AF is not unknown it is reasonably uncommon and usually presents with heart rates well above 150 or even 200bpm. I think maybe chat to your EP about your case and a way forward but do understand that despite anything the doctors may have told you it will take three to six months to recover from the ablation procedure so lots may change in that time.

Forgot to ask what is the race car apart from several hundred rivets flying in formation?

[ling in reply to BobD]

Sorry, but slow AF usually presents with heart rates well above 150? Is this correct? Slow AF, doesn't it mean a slow heart rate?

Thank you

[BobD Volunteer in reply to ling]

AF is a chaotic heart beat, It can be fast or slow but most usually fast, 150 or higher. Occasionally AF can present a rate below 100 or even lower. I should have made the sentence read with a ful stop after uncommon and start again "AF usually present etc etc. " Sorry for any confusion. I knew what I meant. lol

[CDreamer in reply to ling]

Rate & rhythm are different. AF = out rhythm = chaotic or irregular, Atrial Flutter usually presents as a regular Arrythmia & very fast HR, Bradycardia = slow Heart Rate, Tachycardia = fast HR. Sometimes a slow HR results in an irregular rhythm. All are electrics of the heart but it can be quite complex so you can be in AF with a slow or average HR but it is more common to have a fast HR.

It’s possible to experience the whole mix but not at the same time although I’ve had AF & AFL at the same time.

[Frsmith in reply to BobD]

It was a play on racing heart beats. I used to race cars and my a fib causes my heart to go up to 150 to 175 BPM.

[bantam12]

My AF is controlled with meds and my bradycardia is controlled by my pacemaker so it's no longer an issue.

[Truckerclark in reply to bantam12]

My AF controlled by meds ,,,but going in for pacemaker as my heart rate fluctuating from 37 - 85 within seconds on & off ,,,,did you find it helped ,I’ve also got breathlessness does pacemaker help that too

[bantam12 in reply to Truckerclark]

Pacemaker definitely helped with the slow rate and I felt generally better. With the breathlessness I think it will depend what's causing it for you and if the pm makes a difference. Good luck with the pm, was best decision I ever made.

[Truckerclark in reply to bantam12]

Thanks 🙏

[CDreamer]

The pacemaker prevents the bradycardia. The bradycardia more than likely caused the AF, that was my experience.

It’s not a given to develop HF because of LV going out of sync and it still continues to pace itself, just not in sync so your heart isn’t pumping efficiently as it should. I was told similar ie: a high percentage of people with 2 lead PM go on to develop HF which is then treated with re-synchronization PM. But it’s not a given.

Thankfully I was lucky enough to get Bi-ventricular pacemaker to prevent that happening.

Certainly bi-ventricular, resynchronisation pacemaker has worked for me - no more AF or bradycardia since it was fitted in 2018. After 2 ablations I was still very symptomatic with almost daily episodes of AF and similar to your experience with Medicare, my insurance wouldn’t cover the cost of the bi-ventricular PM but thankfully our NHS did but my EP had to fight for funding.

I hope you recover soon, I found that it was 9 months before I recovered fully from ablation & it did give me 3 years free of AF.

Arrythmias are a chronic condition for many people which need to be managed for life. It’s a long journey.

Hope you feel better soon.

[ling in reply to CDreamer]

Your ablations were before the pacemaker?

[CDreamer in reply to ling]

Correct. I was scheduled for AV node ablation which does leave one PM dependent but as the PM worked so well for me, I bailed out. Always an option if things determinate again.

[Palpman]

When total heartblock occurs then the heart's plan B comes to play. An emergency pulse would fire the ventricles at about 32 bpm. This emergency pulse does not always happen or it may not persevere for long.

TRIVIA: Bradycardia can cause arrhythmia. Short QT is normally the culprit that starts AFIB.

[Frsmith in reply to Palpman]

Hi. Evidently I had my first a fib episode two days before the pacemaker was put in. I had felt lousy for about two days and woke up the next morning really concerned with how weak I was. My wife got our blood pressure machine and my heart rate was 32 bpm. She took me straight to the hospital and they put a two wire pacemaker in within about three hours. I was initially diagnosed with bradycardia and afib. They did a heart cath one week later and decided I needed a heart ablation. As I said in my original post, recovery has been difficult! I have high hopes but only time will tell. I really appreciate all the information that I get from you and others on this board! Thank God I don’t have to just rely on my cardiologist and EP’s info. They don’t give you the complete picture. It’s my heart and it bothers me I can’t seem to get solid info from my doctors!🙁

[Palpman in reply to Frsmith]

Quite correct. The members here that have been there and done that are collectively more knowledgeable than GP'S who have limited knowledge in cardiology.

[ling]

Do u already have a pacemaker inserted?

[David1958]

I have had both Bradycardia and AF. It was not until I was put on Flecainide and Metoprolol that I had bradycardia events. My BP was regularly 108/60. HR was 52 at rest. I used to have a 24 hour Holter Monitor once a year. My HR would go down to 40 in the wee morning hours. Now that I am off of those medications, I no longer have these bradycardia events. In my Afib event my atria were chaotic and the Ventricles were at 140 BPM to try to keep up.