Atrial Fibrillation or not?: My query is do I... - AF Association

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Atrial Fibrillation or not?

My query is do I have Atrial Fibrillation or should it be named something else. I have a normal sinus rhythm but I am tachycardic and the heart rate spikes at times. I have frequent ectopic beats but have been advised they are of no concern. Just been prescribed 1.25mg of Bisoprolol.

52 Replies
BobD profile image
BobDVolunteer

Atrial fibrillation is a very irregular and irregular non rhythm. If you have any regular rhythm it is not likely to be AF. AF is merely the most common arrhythmia . If your heart rate is fast (tachycardia) that may be for several different reasons . Ectopic beats are a normal function of a healthy heart and are not normally treated unless the burden is extremely high.

AF can be easily seen on ECG due to absence of a p wave (the little blip before the big spikey thing) .

Have you had a proper 12 lead ECG during any events you may have had?

in reply to BobD

Thank-you for your reply. I have had the 12L 24 hour Holter ECG which reported normal sinus rhythm with periods relating to heart rate of fast, normal and ectopic. My Doctor told me I am tachycardic and asked me how I felt (my choice) about taking a beta blocker to slow down my heart rate. I decided to give Bisoprolol a go and although I am experiencing side effects of the drug that will undoubtedly, should they be permanent, change my enjoyment of life for the worse, it has both brought down my heart rate and also my BP (which was never mentioned by my Doctor) to a healthy level. My Doctor, before the Holter ECG., said I had Atrial Fibrillation but because my heart rhythm is perfectly normal I have my doubts.

BobD profile image
BobDVolunteer in reply to

Sounds like most GPs. The ECG is what tells you not guesswork . What has your cardiologist told you?

in reply to BobD

Hi. I haven’t seen a cardiologist. Just my GP who before sending me to the hospital for to be wired to the Holter told me, after the examination in the surgery, I had atrial fibrillation. GP phoned 3 weeks after the Holter run to say she had received an 11 page long report on it but hadn’t looked through it all. However, she could tell me my heart rhythm was perfectly normal and that where I had had a hot sweating incident during a flat level easy walk my heart rate, which was high for me but still just under 100, went up to 160. There were also ectopic beats. I wasn’t given any information other than that apart from being told by the GP I was tachycardic. I was asked how I felt about taking a beta blocker. What my thoughts were. It was my choice. I will phone the GP surgery to ask for a telephone consultation with the Doctor just to establish exactly what my condition is called. I’m confused by what is Atfib and what is not.

in reply to

I have a Kardia mobile. 6L. I’ll have a look for the little blip.

BobD profile image
BobDVolunteer in reply to

Tachycardia just means fast heart rate. Doesn't sound like you have AF at all but next time you have an event try taking your pulse and see if there is any rhythm or just a chaotic jumble of nonsense. Tachycardia can be caused by all sorts of things from thyroid issues to infection, to atrial flutter (quite a different arrhythmia) etc .

in reply to BobD

Thank-you so much for taking the time to reply to me. From what I have read up on regarding Atfib and Sinus Tachycardia my guess agrees with what you are telling me. That my condition is not atfib. I’m so annoyed with myself for not asking my GP for more information during the telephone conversation she had with me. Idiot that I am not to know what condition I have. Once beta blockers were mentioned to me on that telephone consultation with the GP they were all I could (I have heard such awful stories of their side effects) think of. I did phone my GP surgery to get further information from the Doctor (I’m registering with a new NHS Dentist [had to as the Dentist I have attended for years is no longer treating NHS patients] on Monday and have a health form to fill in. I would have liked to have been able to supply the correct information regarding my health) but unfortunately she is on annual leave until next week and her working week only covers Thursdays and Fridays.Off for a walk now. Many thanks to you once again. You have been very helpful and I know you must have your own problems to deal with otherwise you would not be on this forum. I very much hope you are keeping well.

TracyAdmin profile image
TracyAdminAdministrator

Hello Wirra, Atrial Fibrillation is an abnormality in the rhythm of the heart, where the upper chambers of the heart (atria) is beating irregularly. The Atria controls the normal (sinus) rhythm of the heart, which means the pulse becomes irregular. Common symptoms can be palpitations, chest pain, shortness of breath, dizziness, fatigue or even fainting. You will find lots of information on the A F Association website heartrhythmalliance.org/afa...

Sorry, accidentally replied to this instead of doubledecks' post, so deleted. But since I am here ...

This sounds like sinus tachycardia heartrhythmalliance.org/aa/...

Not life threatening, but you need medication that works without creating more problems from the side effects. If you can tolerate bisoprolol, this would be fine, but for me breathlessness was worse than with AF.

in reply to johnMiosh

Thank-you for adding a note regarding my query. I am keeping my fingers crossed that Bisoprolol side effects (I keep falling asleep, seem to have no energy and get hot and sweaty. Ugh!) will lessen but as Bisoprolol suppresses adrenaline it figures I will have less energy. It helps one problem but seems to create many more. Thanks again for your comments.

Ppiman profile image
Ppiman in reply to

The study linked below looked at the side effects of beta blockers. I think you'll be reassured.

ncbi.nlm.nih.gov/pmc/articl...

I had an ablation for atrial flutter two years ago, but now have similar issues to those you describe with a fast heart rate coming along for no real reason making me feel washed out. A two-week monitor showed brief periods of the high heart rate along with some low heart rate, ectopic beats and some 10-15 second bursts of "afib like activity" as my doctor called it. I took bisoprolol when I had the high heart rate but the cardiologist said it was likely not worthwhile as it took about half and hour to work, by which time my heart rate had normalised.

Steve

in reply to Ppiman

That’s very interesting. With a Cardiologist giving advice to just stop taking bisoprolol beta blocker even although the patient is tachycardic I can now understand why my GP left it to her patient, the patient being myself, to decide whether they wished to start taking the beta blocker or not. Looks like they are possibly only too aware of the horrendous effect these drugs can have on patients and unless the patient falls into a life or instant death category (human beings all fall into that category regardless of whether they are in the peak of health or not) there is no insistence to take the drug. I’m unsure at the moment what to do about the Bisoprolol. I am only on 1.25mg and from what I read that appears just to be a starting point. I have to continue on them for another few weeks before I report back to the GP but should a higher dosage be recommended I may be refusing it. Even although I have only been on Bisoprolol for a very short time I am not the get up and go person I was before Bisoprosol. It’s effect has been instant.

Ppiman profile image
Ppiman in reply to

"Tachycardic" refers to a persistent rate of > 100. That needs treating since it might eventually weaken the heart. Bisoprolol is the best beta-blocker for most people, it seems, but I needed digoxin alongside for the tachycardia to be brought under control.

The doctors who wrote the study I linked to concluded, "Almost all commonly listed side-effects attributed to life-saving beta-blocker therapy in heart failure are no commoner in patients on beta-blockers than their counterparts receiving placebo." Clearly, some people do have important side effects, however, but those doctors found that they were, in general, very well tolerated.

Bisoprolol doesn't have a linear dose response, too, I have read, so 1.25mg isn't truly a "low dose" in the sense of its being a quarter of the usual 5mg dose.

Steve

in reply to Ppiman

Great information. Thanks.

Auriculaire profile image
Auriculaire in reply to

I would not pay too much attention to this study . RCTs conducted by industry often have "tricks" to ensure that side effects in the trials are not much different between the treatment and the placebo arm. There are umpteen books ( often written by people who have worked in the pharmaceutical industry ) that detail how this is done. Many people get on fine with Bisoprolol especially at the dose you are taking. The side effects you mention are very common in those who tolerate it less well. There are other beta blockers ( I changed to Nebivolol as did several other posters here) and find it much better. There are also calcium channel blockers. However if you do not have afib maybe it might be better to investigate controlling your tachy with lifestyle changes like practicing yoga and breathing exercises. There is no point in taking a drug for the rest of your life ( and once started beta blockers can be hard to stop without withdrawal symptoms ) that makes you feel crap just because it is the favourite go to drug of doctors. There are alternatives.

Poochmom profile image
Poochmom in reply to

I am on beta blockers. I started with Metoprolol which gave me those same side effects. Since I have Lyme Disease which more than likely is causing the problem my Lyme doctor told me to change my beta blocker to Bystolic because Lymies don’t do well on Metoprolol. I changed and the side effects went away for me. Just a suggestion. I have tachycardia also. Sometimes AF but mostly just fast heart rate episodes. Good luck to you!

Treschere profile image
Treschere in reply to

Wirra, I am on Bisoprolol too and th symptoms for me became less after a few weeks. 2.50mgs

in reply to Treschere

Thank-you for letting me know. I feel slightly more encouraged to stay on them now. I was considering stopping due to the feelings of anxiety I am experiencing. It has definitely knocked my confidence with regards to driving my car.

If you had a/fib you would know about it a hundred butterflys in the chest and crazy beats waiting for the thud of going back into sinus rhythm. Listen to Bob HD knows everything

kkatz profile image
kkatz in reply to fairgo45

Thank goodness we don't all have the symptoms that you experience.We are all different.Mine dizziness, breathlessness & exhaustion.

Nor necessarily, I was diagnosed with AFib, purely by chance. I had been prescribed an anti-biotic for an infected wound. This particular drug did not agree with me and I started vomiting and vomiting continuously until I noticed flecks of blood in the vomit. I phoned my doctor's surgery and was told to come immediately. There , HR was 140bpm so she performed an ECG which showed Afib. She phoned around to find me a cardiologist (it was a Friday afternoon) because she was concerned about a dissection in the artery, and found one on duty. He practiced at a hospital and he had me immediately admitted - by then I was in NSR. I stayed the weekend . Without going into all details of visits etc, suffice it to say, I am on the usual Bisoprolol and Xeralto and have had a cardioversion, but I never ever had any of the classic symptoms and still don't. I don't think I am unusual, I think symptomless AF is quite common.

Which antibiotic did you take? There are some which actually provoke afib.

Augmentim (I hope it's correct spelling ) but I do come from a family of 'A fibbers' my 3 sisters all have it !

That is one of the safer antibiotics . I can tolerate it with no problems and it has never set off myafib unlike Ciprofloxacin.

in reply to Auriculaire

Good to hear. Perhaps my symptoms will settle down. I hope so anyway. I took the car out this afternoon and I am someone that loves driving. Well I did anyway. For some reason (where has that annoying underlining come from ?) when I was driving I felt anxious and nervous and yet my heart rate (I checked) was absolutely fine. I have not felt that ever when driving. I am still feeling that way. Is this another side effect of Bisoprosol! I am fed up now and have opened a bottle of Malbec. Heyho!

in reply to fairgo45

My goodness. These symptoms sound awful. I have not had experience of such. I don’t think I have Atfib., and that’s really why I joined this Forum. I knew that the right people to tell me I did not suffer from Atrial Fibrillation we’re the people who did suffer from it. I absolutely agree with Bob, but I haven’t yet been told by a medical person (my GP., who is holiday until the end of next week so I will not know what she has on my file until then) that I do not have Atfib. Only that I do have it but that diagnosis came before I had the 12L Holter ECG. My own 6L Kardia report always shows Sinus normal and no Atrial Fibrillation. My thoughts are that I have Sinus Tachycardia but I can’t label myself with it unless a medical professional agrees with my self diagnosis.

Thanks for replying to my posting. Thank-you everyone.

bantam12 profile image
bantam12 in reply to

You can have Afib without knowing, some of us don't feel it.

bantam12 profile image
bantam12 in reply to fairgo45

I didn't know I had Afib and still don't know when it's happening, some of us don't feel anything.

And my afib symptoms were...................none! (other than the ridiculous fast heart rate). Afib appears differently to everyone , or so it seems.

AstroFish profile image
AstroFish in reply to KMRobbo

Agreed - I didn’t even know I had it. Only one “incident” in the middle of the night while I was asleep recorded on a week long monitor. The things that were causing me distress were perfectly harmless and the one serious thing was happening without my knowledge.

Yes I stand corrected my cardiologist said once he had lots of patients who never knew they had a/fib till it was picked up randomly on an ECG I was the opposite I was very symptomatic as I described but 3 ablations later I'm much better still on rate control pills and bloodthiners but those early years were a nightmare.

It could be Atrial flutter. The ECG will look fairly normal but at much higher than your normal rate. I dealt with that recently and had an ablation that fixed it. But don’t just go to a GP, see an electro physiologist and get some real answers.

Hi thought I’d share some my arrhythmia journey.

I started experiencing extremely weird palpitations I then had a holter monitor on for 72 hrs in that time while sleeping my heart started going extremely fast dropping beats and strange flip flop experience hadn’t had before my Apple Watch said Afib took monitor off at 12pm following lunch time and by tea time in an ambulance with what I thought was a heart attack heart goalloped to 175 I collapsed out of breath sweating and in ambulance they hooked me up and said looked “fibby” time got hospital it had subsided and was advised to start bisoporol and the monitor would have information from the weekend I was wearing it.

Report came back I had ectopic beats and Atrial Tachycardia. After being given 2.5mg bisoporol my heart then went to low and I was so flat and exhausted they said try 1.25 so tried this, week later back to hospital chest tightness and still fast heart told me not worry take bisoporol

Rushed hospital again two weeks ago with heart rate going off the rails again, kept in this time and monitored again stable cardiologist decided get an echocardiogram and Alive Cor heart even monitor which I can’t get to end august. Waiting results echo.

The side effects bisoporol take a few weeks to settle into your system

The scary episodes are so frightening of heart loosing it and I’ve decided stick low dose just now, I believe this will need increased and await the results of all tests

The tachy moments for me are sporadic and I can’t tell when they will happen but they are extremely scary, having the heart at a steady rhythm is better for the body all round that heart rate being too high.

Wish you luck and take care.

fairgo45 profile image
fairgo45 in reply to AGCG2

Not just me then

Hi Wirra, I too like you have experienced a lot of ectopics. Tachycardia and palpitations. I am now on 3.75mg of Bisoprolol a day and yes it was horrendous at first when starting taking it 1.25mg at a time and gradually increasing it over the weeks but I now feel so much better in myself and physically. I can’t run or do much exercise but I can walk my dogs and play with my kids now which I was unable to do so before. I was literally sofa bound. However it’s been over 2 months since my last full on episode and I see a cardiologist regular. I paid privately and now see the same cardiologist on the NHS 😌 so just take it day by day and hopefully your be back to a normal state soon 😌

Hi Wirra, Your story sounds like my own, and I bet many other people's too. I started with tachycardia and ectopic beats with just very occasional suspected short bouts of atrial fibrillation which were flagging up on my personal event monitor, but whenever I had any kind of official test, it was absent. This went on for four years, and, like you I was prescribed a precautionary dose of Bisoprolol 1.25mg.

After four years of on/off testing, I began to have very clear signs of AF. I was again monitored with a 7 day event monitor provided by my cardiology clinic, during which time I managed to record enough periods of arrhythmia. I was then quickly diagnosed with paroxysmal AF and given an anticoagulant and a 5mg dose of Bisoprolol.

I'd say trust in the findings of your tests to date but remain aware that things can change and also that, in any case, it may be elusive as far as a firm diagnosis is concerned. It's just the nature of paroxysmal AF.

As far as quality of life on Bisoprolol is concerned, I too felt quite drained initially on a dose of 1.25mg. Four plus years and a diagnosis later, I am now on 5mg and certainly wouldn't agree to taking a higher than 5mg dose, but even on 5mg I am tolerating it more and more as time goes on.

It's not an emergency, but I think that, at your next opportunity, you should ask your GP any questions that you have, so you understand exactly where you are at the moment, and remain alert yourself for any changes that may happen in the future.

in reply to Callendersgal

Thank-you to everyone who has shared their story. I hope this reaches out not only to yourself Callendersgal but to everyone who posted in response to my query.Best to all.

Off to enjoy a slow walk around the paths of Edinburgh now. Well …….., local to my area anyway. Let’s not overdo it on 1.25mg of Bisoprolol. 😁👋

Callendersgal profile image
Callendersgal in reply to

😀

A couple of things that don't seem to have been mentioned yet: 1.25mg seems to be the lowest dose of bisoprolol used. Many of us are on or have used higher doses. Bisoprolol is one of those drugs that have a significant impact initially, but which the body seems to get used to and tolerates after a settling in period, maybe over a month or more. It is also a drug which should not be suddenly stopped, but tapered down slowly if you are withdrawing from medication. My (limited) experience is that although the bisoprolol slows the heart's response to exercise, after pushing yourself a little the heart rate will eventually rise sufficiently to enable you to continue. For instance, when walking up a long hill, it seems very hard at the beginning but later the heart catches up with the load and it becomes easier.

I would agree with others, you need to ask your GP to refer this tachycardia problem to an EP for investigation.

Sounds like you had an episode of sinus tachycardia under conditions that would tend to cause this, heat, exertion, possible dehydration, etc..Unless you are getting this frequently or have other symptoms accompanying this, it would seem to me that the side effects of the beta blocker are worse than the condition you are being treated for. This is somewhat controversial and you should be in discussion with your EP or cardiologist to come up with a treatment plan. A stress Echocardiogram could provide you with more information to make an informed decision... Just my 2 cents..😗

Sounds similar to me. Lots of ectopics with maybe a 3 hr tachycardia episode approx once every 2 wks. Consultant said non life threatening and to carry on with my Atenolol. But non life threatening or not they are still scary but above all never knowing when they will strike a worry.

I use a Kardia 6L ecg machine (£150) and it tells me if I have AF and I think it’s accurate although diagnosis isn’t straight forward. Mine is brought on by exercise, especially cycling after a break eg cycle-lunch-cycle. Typical pattern is to get ectopics after some exercise eg 4 per minute, rising to 20 after more vigorous exercise and to AF (multiple ectopics indeed chaos between each R wave). I’ve had the Kardia 18 months and have done about 300 ecg’s! Important not to get tense, over-react nor expect doctors to jump every time you detect something but for me it’s good to know what’s going on and spot trends eg increased frequency. I can generally spot AF (absence of P waves on Lead II) before the auto diagnosis.Good luck!

in reply to splashrollandplod

I have the same Kardia (not off for walk yet as previously posted. Bath first. Then walk. Then car drive which I’ve being avoiding until I knew how I would react to the drug) which I set for 5 minutes. Every Kardia report says normal sinus and no rhythm or heart rate abnormalities. That same reading has always been shown both before and since taking bisoprolol. Kardia reading was (and is) always taken at rest and although the heart rate was shown as high when at rest before I went on Bisoprolol it was within, just below 100, normal range. Walking took me over the 100 though. Hit 160 during a hot and sweaty period (only lasted a minute or so) when I wore a 24 hour Holter. Goodness knows how high it went when I climbed hills. Hills I had to stop and take a break on after 20 steps. I counted them and pushed to make the 20. On Bisoprolol my heart rate is lower at rest as is my blood pressure which was high normal (I have never needed any medication for blood pressure) before.

Thanks very much for your update. This forum has been so helpful to me.

splashrollandplod profile image
splashrollandplod in reply to

I am 65. Walking on the flat my HR is about 100, uphill 125. If it goes above those numbers unexpectedly I do a Kardia. 2 weeks ago I hiked in the Cairngorm hills and 3 hours in my HR hit 138 on a very slight incline so I did a Kardia test showing 20 ectopics/min. I had to walk for 10 mins then rest to control it to ascend to get back. Then after 40 mins downhill I had a sudden 174 bpm so tested to find AF it went back into rhythm shortly after.

in reply to splashrollandplod

Although these high rates must have been very concerning for you ……… blimey!, how adventurous of you though. Cairngorms hike for three hours. I’ll need to get myself up some hillocks. Are you on beta blockers with these high rates happening?

splashrollandplod profile image
splashrollandplod in reply to

Beta blockers no, indeed not on any meds. I’m not too concerned at high HR except when it’s unexplained. My ecg ramp stress test at the hospital saw my HR up to 168 and I felt fine although had some pre AF ectopics. That was a sort of benchmark that I have been avoiding - ease off at 160, stop at 170ish ….. (PS bit of a mistake climbing Cairngorm then going down the other side …. only way back was up, so no bake out option!).

in reply to splashrollandplod

Well done anyway. I have a friend who gave up on all the drugs (she tried 6 different ones) she was prescribed. Side effects were more damaging to her than the problem they were trying to fix. She prefers having the problem. I have yet to make up my mind about problem or drug fix.I have a need to get as much information on things right down to the last full stop. My understanding from the messages I have read on this forum is that I am probably of a lesser concern medically than many others. However, as I don’t truly know what’s going on with me, I may be very stupid in thinking that.

To know what’s going on with me (and much more …… may have regrets ….. ah well!) I am requesting a copy ( paper, computer or both. £10 or £50) of my NHS records. I don’t have to explain why I want a copy which I am thankful for. My GP is very nice but nice doesn’t cut it. She is a bit too evasive and although she may have a legitimate reason for being so I still want to know everything. Or maybe nothing! Who knows. We shall see.

I think they can hold back on some things though. Maybe comments they don’t want you to see. Such as ‘pain in the neck’ and not the patients neck.

Treschere profile image
Treschere in reply to

Wirra, you don't need to pay money for your information. Download the NHS app and set it up, this will enable you to order repeat prescriptions from it and look at your medication history. Once you have done this you can request your information to be available to you and then everything, including results of scans, consultations and notes etc will be there for you to see yourself.

in reply to Treschere

I didn’t know that. I’ll have a go at it and see what comes up. Thanks.

in reply to Treschere

Hi. No luck accessing my records on the NHS Scotland website. I have to apply in writing if I wish a copy but should I just wish to view them I can request to do so at my GP Surgery. I think it’s the Practice Manager who deals with these requests but a member of staff may stay with you when you view. NHS England and Wales are different.

Treschere profile image
Treschere in reply to

Hi Wirra, it is an App on your phone not a website as that would not be secure.

Wires, based on my experience you have a dysrhythmia of sorts. Sounds like Afib but what does your cardiologist say?

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