Dear all
As always a question.
Sadly had a very short (5mins) episode tonight . First one since my cryoablation 11 months ago.
Why dies my usually low/ perfect blood pressure shoot up when the af hits? No hbp before? Should it not be low when af hits?
Any views and reassurance welcome 🙏
Rod
It’s virtually impossible to get an accurate BP reading when in AF. If your pulse is rapid and irregular or slow and irregular it is obvious not functioning the same as when in normal sinus rhythm........l
Just from technical point of view...
The heart is a precharged pump, because the ventricles get filled with the blood from contracting atria. In NSR, it helps to achieve quick filling of the ventricles, what is very important when the bpm is high. When in AF, the atria do not contract in a regular way, so precharge function is off. At high bpm, filling of the ventricles gets poor and blood flow rate goes down (to 60-70% of normal), causing drop in BP.
There are cases, where people have "strong" heart, so the sucking function of the ventricles fills the chambers relatively efficiently, even without help of the atria. In such cases, the increase in HR, when in AF, gives an increase of blood flow-rate, causing the BP to go up.
I believe to be such an case - that's the reason that I am practically symptom free when in AF. My resting HR is about 50, all my life, being the sign that my heart can perform its task easily.
When in AF, my HR goes to 80-90, with good filling of the ventricles, so the blood flow-rate remains sufficient for my small body (only 150 pound). The only symptom I have is some "uneasiness" in the chest, nothing else.
Hope, it makes sense...
Interesing reply but my reasoning is as follows.
BP is not just a function of how well your heart is working. It is mainly a function of how elastic your arteries are. Different chemicals in our body react to constrict arteries for very good reasons. The fight or flight reaction does this so that when that sable toothed tiger takes a bite out of you then you don't bleed to death. We know from Boyles laws that pressure within a constant volume is itself constant and it follows that if you reduce the volume (constrict the size of the arteries) then the pressure goes up.
For many of us AF induces stress which creates this effect so our BP rises. Caveat, we are all different but that is how mine works.
Bob My af definitely produces stress as I am not good at dealing with it and very symptomatic.
So: high BP when in af is not unusual, af produces the fight/flight.
In your experience of helping us af bods is getting small breakthrough s unusual. Bit down today as no Afib since my ablation 11 months ago and naively thought I had beaten it😊
Thank you
Rod
I utterly agree that the problem is more complex than what I have said, but just wanted to shed some light on it. Us, the elderly ones, have in general the problem of poor functioning of the HR and BP regulation. That said, any analysis is hard to perform with sufficient accuracy...
Thank you Makes sense. My main symptoms when I’m af is stress and thumping heart.
Might have been too much sugar yesterday?
No other reason?
Bloody thing!!
Anything that pushes up your heart rate will also push up your blood pressure. It often will swing wildly from low to high again.
Last time I was in hospital with AF, I asked the doctor that question, because I take Atenolol to reduce my BP. He said that he’d be more concerned if it was low, because that would mean my heart was struggling to cope, and it wasn’t.
Sorry to hear this 😕 Really hope it’s just a freak one-off event. (Very glad it self converted so quickly at least.)
I’m no expert at all, but my personal anecdote is that my rate in AF is always high (140-200 bpm) and my BP is sky high. It worried me when I took it myself at home, and it visibly freaked out the nurse who took it in hospital. The consultant, however, didn’t bat an eyelid. He said the heart is under stress, it’s nothing to worry about and there’s no need for me to take the BP in AF unless feeling faint etc, where the concern would be to see if it’s going too low. Additionally, the electronic bp monitors won’t necessarily be accurate. So ever since, I’ve taken his advice and not even tried to take my BP while I’m in AF 
x
Mine ALWAYS goes up ... anxiety l fear.
One of the first signs I get of a PAF episode is a strong feeling of pressure in my head. I've assumed it's a rise in BP but I've never checked it out. Wonder if anyone else gets this?
Now they have increased the base pulse rate of my pacemaker, my blood pressure does not drop off the scale when I sleep - my pulse rate was going down to 30 - and I was waking up paralysed from the eyelids down.
I take up to 6 readings a day so can comment on my own findings. When in persistent AF for many months my BP was typically circa 128/95.
Now I am in NSR my BP is typically 132/88.
I have 4 ways of reading pulse and all give different result when I was in AF (and all identical when in NSR). The BP reading relies heavily on pulse to be accurate, so therefore my BP readings in AF arent accurate.
Mr FizzCould you please explain to me your af. You say that when in permanent af your stats are good and in NSR they are good. It always confuses me that if permanent af is no problem to you then why do we mostly try to stay in NSR ( ablation/strong drugs/pacemaker etc).
What does permanent feel like. I know that when I have af it feels horrible.
Rod
I have pesrsistent AF 24*7 when not on amiodarone tablets (200mg per day). When NOT in NSR I feel tired and lethargic; when IN NSR I feel 10 years younger - for example I did a 22km mtb ride yesterday.
I will have catheter ablation next year to get off the amiodarone.
The test was having electric cardioversion - it worked to put me in NSR for 8 days but I felt sooo much better during those 8 days, so the EP put me on meds to keep me in NSR til the ablation procedure in 12months. (If I didnt feel any different I wouldnt bother with meds and stay in AF)
For me, being in or out of NSR is like an On/OFF lever to my life and energy levels. Its a game changer for me to be in NSR from persistent (24*7) AF - some people may not feel any difference.
AF when getting into bed
Very high blood pressure
High Blood Pressure during the Night.
From high to low blood pressure
