Ongoing AF with low HR

[mrsg46]

My AF seems to be back after four blissfully trouble-free years (for AF that is, not life in general, lol) . It started last Wednesday out of the blue and has continued ever since. Occasionally I get a reading on my Kardia of Sinus Rhythm with Supraventricular Ectopy, which is what I thought it was at first. However, the ongoing AF has been showing, on average, an hr of 73 bpm, so I wondered if anyone else has experienced this low hr and how they have been advised to proceed if so.

Thank you for any help you can give. Fed up now and am debating making an appt at my surgery to get an ECG, just to see whether the Kardia is giving false readings (although I feel rough enough to think not).

[CDreamer]

Sympathy. It’s horrible when AF returns after so long, for me felt familiar and alien at same time. Yes, my AF went to slow AF - I went pacemaker route and have had 2 very mild AF episodes since implant in 2018.

[mrsg46 in reply to CDreamer]

Thanks CD, I've been reading all your very informative posts over the last few years and really value your advice. Interesting that the return of AF for you was also with slow HR.

I guess it remains to be seen how this will play out, given that we're very much not out of the woods in terms of Covid and the NHS has a lot of catching up to do with routine appointments.

[CDreamer in reply to mrsg46]

I agree with Bob - sooner on the list, less waiting.

[Bruceyboy in reply to CDreamer]

Can I Ask what meds you are on I had pacemaker 6 months ago as Af with bradycardia but put on xaralto and Sotalol Feel good except get a bit breathless at times from the Sotalol I think

[CDreamer in reply to Bruceyboy]

No meds other than A/Cs

[captainKFF in reply to CDreamer]

Hi,, could share whether slow Afib is less symptomatic than fast Afib and if after placement of pacemaker the Afib became less frequent and shorter in duration.Regards

[BobD Volunteer]

I think you should speak to your GP about getting a full twelve lead ecg done and e mail a copy to your EP for their advice.

[mrsg46 in reply to BobD]

Thank you Bob, I'm beginning to think that it's the way forward now as well. Good idea about emailing a copy of the ECG to my last EP as he was so helpful and kind when I was treated by him previously.

[Finvola]

Sorry to read this mrsg - such a let down for the soul. I would definitely try to get a full ECG done to clarify the position if possible. My heart always behaves itself impeccably when I go for a 'real ECG'!!

My Kardia reported possible AF last week with a heart rate of 79 but when I looked at the trace I could see p waves and that the trace was regularly irregular - so decided it was ectopics not AF - 30 of the darned things in a minute and it lasted for a couple of hours. I blamed my second COVID jab. Examine your Kardia trace on a printout and make sure it is AF and not ectopics. All the best.

[mrsg46 in reply to Finvola]

Hi Finvola, thank you, yes it's really disheartening (no pun intended!) to find the AF has shown up again after all this time.

My Kardia has on occasion in the past shown 'possible AF' but then it's come to nothing and I've put it down to ectopics. This time it's been consistently showing AF except for twice showing readings of Normal Sinus with Supraventricular Ectopy, which is new, never seen that before.

I've got my 2nd Covid jab on Wednesday so I hope it won't make things worse 🙄

[secondtry in reply to mrsg46]

2nd Covid jab could make things worse but equally with the weird thing that AF is it could make it better! I have experienced gulping a cold drink both starting and stopping AF. Good luck.

[irene75359 in reply to mrsg46]

On a thread a week or so ago the 'Normal Sinus with Supraventricular Ectopy' reading was mentioned, apparently it is a software update, I have been getting those too not having had them before.

[mrsg46 in reply to irene75359]

Hi Irene, that's interesting, thanks. I hadn't noticed when the update happened but it explains why the new reading is coming up.

[baba in reply to mrsg46]

"Normal Sinus with Supraventricular Ectopy, which is new, never seen that before."

Kardia is now reporting etopics, since new software update.

[Maggimunro in reply to Finvola]

Funny, Finvola that you should say that. When I had my first AZ jab I felt fine for about 5 days and then had a troublesome 3 days of ectopics: runs of seemingly missed beats every 5, 7, or 9 beats. I hope yours like mine settled quickly.

[Finvola in reply to Maggimunro]

Thanks Maggi - More or less the same with me after the second jab - it peaked a day or two ago and (fingers crossed) seems to have settled. It's so easy to blame the jab but I haven't had a run of ectopics like that since I tried to reduce Flecainide 5 years ago.

[Hidden]

73 bpm is a normal heart rate, AF or not. After 3 ablations, I’m guessing you are taking an anticoagulant, so electrical cardioversion asap could give you a good outcome

[Tobw]

I was put on Bisoprolol in 2008 and ever since then, my heart rate in AF has been low - typically between 60 and 80 bpm. My episodes have lasted as long as four and a half days and, at first, I was concerned enough to go to A and E on a fairly regular basis about it. However, I have been told on two occasions (once by a GP and once by a consultant) that they would have no concerns about me being in AF for months given the rate my heart beats at when I'm having an episode and so, as I'm lucky enough to be able to all but carry on as normal when I'm in AF, I'm nowhere near as worried as I used to be - although there is always that feeling of wanting things to return as they should be of course.

[cuore in reply to Tobw]

Woah -- " they would have no concerns about me being in AF for months." Are you saying that a consultant and a GP would not be concerned if you were persistent for months? In my evaluation as a seasoned affiber, your GP has no business making such a false statement because he is not qualified to draw such a drastic conclusion. It is in the persistent stage that the heart really remodels. Is a consultant an EP ( I don't know the NHS system)? I am not an MD, so I have no background on the relationship between a low heart rate in persistent AF and the rate of remodelling. But, you might want to get a different viewpoint from the two you have had. Also remember "AF begets AF" and you have already had 4 1/2 day episodes.

[Lucymoo in reply to cuore]

I do feel your reaction to tobw a little angry. I’ve had similar messages from my consultant so please be respectful of different opinions you may not agree with

[cuore in reply to Lucymoo]

Oh dear. So, you were allowed, like me, to get to the persistent stage and remain in the persistent stage for months allowing your heart to get remodelled and fibrotic, having to have very extensive ablation, but still struggling to maintain sinus rhythm, and currently having to go for another cardioversion. I would appreciate some enlightenment, because I am having a hard time trying to remain in sinus. If only there had been some concern that my heart was left in persistent for months. In fact when I finally got ( and privately) to my world renown EP, he said I was one of the most complicated cases at the six month persistent stage, and had I not had an ablation then I never would have been able to return to sinus. And I still cannot remain in sinus. If I can help someone not follow my footsteps, and get to and remain in sinus, I will. Other that wish to reject my experience may certainly do so.

[Tobw in reply to cuore]

Thanks for your concern, but I have had AFib for fourteen years (at least that's the first time I noticed something) and its progress has been very slow. One thing that soon becomes obvious is that AFib is different for each individual. so just because yours has progressed a certain way, it doesn't automatically follow that mine will. I'm lucky in that AFib plays a relatively small part in my life and I'm able to shove it to the back of my mind most of the time. I post on here far less often these days than I used to, but I thought I could, perhaps, offer mreg 46 a little bit of reassurance by telling them about my experiences.

A couple of things, you hone in on what the GP said while ignoring that a consultant said the same thing separately and I have also had an appointment with an EP since then when I mentioned what I had been told and he seemed okay with it (I think he'd have told me if he wasn't). Also, I'm not in persistent AFib. When I was first diagnosed with it, I was told persistent AFib was when an episode lasted more than five days and, having checked this just now, down the years that figure seems to have changed to a week for whatever reason - I've never had an episode last as long as five days in fourteen years.

[cuore in reply to Tobw]

Glad to hear you are doing so well. Keep it up.

[TheKnitter]

Hi, I went back into AF in December last year after 2yrs in sinus rhythm, had my second cardio version in Feb this year in and out of sinus rhythm due to AF episodes HR of 41 - 45 never any higher, now awaiting an ablation, I just get on with life and try not to let it get me down as I feel that makes you feel worse although I know it is worrying. I hope you get things sorted.

[Hidden]

I spent a couple of years being in full blown AF with a heart rate in the low 70s. EP said I would soon join up the dots and it would become permanent rather than two days on one day off.

However, this didn’t happen so he upped by Flecainide to 100 twice and can now go several months without an episode. And then only at 75!

[HiloHairy]

My events predictably start in the middle of the night, last approximately 15 hours and if left untreated stabilize at approximately 160. The few times that I went to the ER (sorry, can't remember what your Brits call it) they put me on a drip of diltiazem, monitoring my rate, aiming for it to be below 100. This gave me the idea to crudely copy their action at home.

With cardiologist approval I started to monitor with my Kardia and a blood pressure cuff and guided by the readings take fractions of diltiazem and metoprolol tablets until my rate went into the target region. Doing this, I can usually get it to stabilize in the '70s or low '80s.

Reporting this to one of the cardiologists I see elicited a response from him that I've been able to take away much or all of the risk and damage of the attack. If my guy is correct, maybe your slow rate events, while anxiety causing and frustrating, may not in the big picture be that terrible a thing.

[Hidden in reply to HiloHairy]

Same for me always at night lying down and always slow heart rate ..when I was up and about doing things busy it was at least not noticeable. I self medicate too with magnesium and after taking 400mg it went away within hours...only came back when I stopped...so ibhavent stopped taking it... I have forgotten and got dehydrates and on those days I had wobbles but not a fill blown no proper heart beat event. Just thumps and bubbs and drops and things. My pb has become higher as it was always usually low and that runs in the FAM. So glad I can stop it so easily compared to other people. I'm lucky to have found the cause and sorted it it seems. Hoping it doesn't come back any time soon.

[Snookersteve]

Hi mrsg46. It may be worth seeing your EP privately it will be a lot quicker than the NHS at present due to Covid. If you need any treatment such as cardioversion then he/she can refer you back to the NHS. The EP might put you on Flecainide (providing your heart is sound apart from the AF). In my particular case (although not for everyone) I have found Flecainide followed by a cardioversion to be a lifesaver.