Persistent af and high heart rates q

[grandadbren1]

I have not been on here for a while. I have sailed along in paroxysmal af for last 5 years. Since october 2020 i have been getting out of breat a bit when walking and my november pacemaker download showed heart rates of 190 and persistent af i was medicated with an extra 5mg nebivolol to slow heart rate. My pacemaker download showed i was still in persistent af wit heart rates of up to 172 for 20 mins i have now been given a prescription for digoxine. I wonder if anyone else with similar situation took digoxine and did it work by lowering heart rate. Have i any chance of going back into paroxymal af.

[The_Lord_is_with_Us]

That's pretty high tachycardia. I probably wouldn't be that concerned if it was 130 or less.

I've had AFIB for 12+ years. 4 ablations. After 10 years of normalcy ... AFIB came back in AUG with rapid ventricular rate (RVR) tachycardia. Mine was the 130 variety. They gave me Diltiazem 30mg 4 times a day to reduce rate.

Anyway ... contacted EP and had ablation in OCT. Cardiologist told me the ablation would stop the AFIB and stop the tachycardia. He was right ...... both are gone.

It sounds like you might be a candidate for an ablation. It's a fairly easy to tolerate one-day affair ... and may very well get you back to normal. Might you consider one?

[CDreamer in reply to The_Lord_is_with_Us]

Not quite as straightforward with a pacemaker and whilst the procedure itself may be a one day affair the recovery, for many, could be months.

[grandadbren1 in reply to CDreamer]

I am hoping that digoxine will bring the rate down but also hoping it could put me back into paroxysmal af. Consultant had discussed ablation with me but i was then in paroxysmal and asymptomatic so preferred to carry on i now seem to just beable to speak to a cardio nurse who says ablation would not work. I really would like to speak with consultant and may press for private consultation ?

[CDreamer in reply to grandadbren1]

Sounds like a plan. I would do your research because there are studies which show that medication to control heart rate - which is important - can offer good QOL. I think it important to note that’s ablation often offers freedom from AF for a number of years but often needs to be repeated.

Explore all options with an open, informed mind & question everything with your EP.

Best wishes & hope you get a result.

[Diver2 in reply to CDreamer]

I had a pacemaker in during 2 out of three of my ablations. They wound up leaving me with additional A Flutter and did not work. Th second ablation left me with lower leads disconnected and thus not working. We learned this when the pacemaker was replaced after the batteries died 12 years later. My pacemaker does not pace my heart as my pulse is high when the af hits, otherwise the digoxin keeps it abeating at 55 bpm

[CDreamer in reply to Diver2]

Dislodging the leads is one of the complication risks of ablation with pacemaker.

[DevonHubby1]

Hi, wife suffers from PAF and after a long bout of AF was hospitalised for a week. They used a combination of Bisoprolol and Digoxin to control rate and try to knock her back to SR. Was taken off Digoxin 3 months later as she did eventually reverted to SR.

[grandadbren1 in reply to DevonHubby1]

I had spoken with consultant in October 2019 but as i was paroxysmal and mainly asymptomatic i was happy to continue as i was however he did arrange echocardogram and to see me in march 2020 of course covid took care of that i finally got a call fro a nurse who said echo was fine see you in october for pacemaker download and this revealed the high heart rates but i could only speak with the cardio nurse who said ablation or cardioversion would not work. It seems covid has now prevented me seeing my consultant to discuss this further i am just hopingthat the digoxine could put me back to paroxysmal af.

[grandadbren1 in reply to DevonHubby1]

That is what i am hoping for i can cope with paroxysmal af but to be back in rhythm completely would be fantastic thing is though apart from short of breath sometimes walking uphill i am unaware my heart rate is so high which worries me as i know its not good even if for 20 minutes.

[Barb1]

I know that you can still have AF with a pacemaker but I didn't know that you could have tachycardia. I thought that the pacemaker controlled the rate. Confused.

[CDreamer in reply to Barb1]

It depends whether or not you have had a AV node ablation. Most pacemakers will pace the heart only when the heart rate falls too low. Only when the AV node is abated will the pacemaker take over pacing the heart completely. I have pacemaker without AV node ablation and still get tachycardia and very occasional AF. If the arrythmia becomes too symptomatic my only remaining option would be AV node ablation which would make me entirely PM dependant.

[Barb1 in reply to CDreamer]

yes that sounds like what I would need

[grandadbren1 in reply to Barb1]

The idea is the drugs drive the heartrate down butthe pacemaker kicks in if the heart rate dropslow.

[ETHEL103]

Hi I also take Digoxin and it has brought my heart rate down. Bete blockers even at low dose took it too far. 40 during the night and 50 during the day. Hence walking puffed me out.

[grandadbren1 in reply to ETHEL103]

How long have you taken digoxin?

[Diver2]

I take digoxin. Still have occassional very high heart rats, but not daily as before. I have been told to go to ER if rate over 158. I listen to music therapy developed in UK and stay in sinus rythm with (2) A flutter and P AF rotating in occassionally.

[The_Lord_is_with_Us in reply to Diver2]

Is it the famous UK hypnotist Glenn Harrold? I listen to his music and it is quite calming and soothing.

[Diver2 in reply to The_Lord_is_with_Us]

No and it is not hypnotic therapy music. Tho I do meditate to some htm... it was actually composed in a class at a UK University in their Cardio music therapy class. Every time I say the name my post gets blocked. It’s great because the base line progressively leaves out beats for longer and longer periods... which you heart then fills in. I started looking for music to help about 10 yrs ago when I realized certain beats were triggers. I thought if they can throw you into rhythm then perhaps they could throw you into sinus rythm. So far it’s been my saving grace!

[Spangle14 in reply to Diver2]

How strange that it should get blocked if you say the name - I'm sure many of us would like to know more about it, as it could be of real benefit to us. Would be really grateful if you could message the details to me. Many thanks

[Diver2 in reply to Spangle14]

I just started on her an haven’t figured out how to message

[Diver2 in reply to Spangle14]

The music is Weightless by Marconi Union. It’s 8 minutes long and I just play it on repeat

[Spangle14 in reply to Diver2]

Thank you so much, will take a listen

[grandadbren1 in reply to Diver2]

Thank you for the info I will try it tonight.

[grandadbren1 in reply to Diver2]

What is the music please. I am now in persistent af with the high hr coming in every now and then according to my pacemaker i could not get a full picture from the nurse who rang me but i do know i had hr 172 for 20 mins on 4 feb and few days before rate of up to 180 the increased 5 mg of nebivolol they put me on in december has not brought hr down so they want me to take digoxin i am willing to try music therapy to get me out of this .

[grandadbren1]

My heart rate before the permanent was about 55 to 80 but my sinus rhythm was out when in af and i was never outof breath however now iam in continuous af and my heart rate is at times going up to 180 i do notfeel it but i do sometimes get breathless walking uphill . I am so hoping the digoxine takes heart rate down and perpetual af back to paroxysmal.

[bassets]

Hope you are able to sort this out and feel better soon. Good luck.