AF and a low pulse

[Kendalghost]

Hi Folks,

I'm currently on the waiting list for my second ablation, the first gave me about 18 months of normality. I can't take beta blockers as my pulse is normally in the low 40s. The cardiologist wants me to have a heart stress test to see if I can take the levels of Flecanaide that he recommends. The hot weather has meant that even taking a short walk in the heat has set my heart off and I feel like collapsing. I need to exercise as I am diabetic but in remission can anyone suggest anything that might help me cope better with the heat??

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This post was produced by Singwell a few days ago and it prompted a good few suggestions which many found helpful……

healthunlocked.com/afassoci...

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Join a gym? They usually have a/c.

[secondtry]

What level of Flecainide is he prescribing? Didn't know there was a connection between this and a stress test. I had one (didn't push myself to reach the level suggested) and am very dubious of the risks unless you are satisfied they are essential. I particularly didn't like being surprised with a disclaimer for signature whilst waiting to start on the treadmill.

[Kendalghost in reply to secondtry]

Before I had the first ablation the dose was 50mg and that could be repeated after 30 minutes. It only worked once so I didn't bother with it. This cardiologist said the doze should be 200mg or higher. I try to walk when I can, obviously this heat caused me issues so as long as they want me to walk on the treadmill I would do it. My GP said that they may not use a treadmill as they could inject something that would have the same effect. I would rather use the treadmill as it I felt unwell I could at least stop.

[Ppiman]

Does your AF increase your heartrate at all? My AF, rare as it is thankfully, seems to cause a rate of 80 and upwards to 120 or so. I get this without AF, too, and also lots of heavy palpitations.

Have you got a home ECG device, by the way such as an Apple Watch or Kardia? I have used both and find them useful.

Steve

[Kendalghost in reply to Ppiman]

My AF does increase my heart rate similar to yours. The highest has been around 120 but mostly in the 80s and 90s. Now though it doesn't always increase the pulse and I know that I am having an episode as my bp monitor advises if the heartbeat is irregular...plus you can actually see the flash for every beat and see how irregular it is.

[Ppiman]

Mine is similar but if I try to work when it's like that, it will go up to 135 or more very easily. It feels uncomfortable like that because it brings on a kind of chest discomfort and a slight shortness of breath. I've pretty much managed to get used to this happening now but it used to make me very anxious.

I find that the ECG devices are better than a BP machine (except for a couple of really advanced models from Withings and Omron) as they only show the pulse and whether it is regular or not. My own pulse is much more often irregular because of ectopic beats than from AF these days, thankfully - yours might be the same, perhaps?

I sometimes get spells of long runs of these beats (mostly PVCs with some PACS and other odd looking things). Often, they come bunched together as three or more and when that happens it feels, for all the world, like AF, i.e. hard to just put up with (but still nothing like it feels with a really fast rate which I've had only once since my ablation in June 2019).

Steve

[Kennyb1968 in reply to Ppiman]

Hi Steve,

I am the same since I started daily flecanide (250mg) about 3vmonths ago. I was disappointed initially as I was getting short (15mins-2 hours max), low rate (70-110bpm) and mildly irregular (more like clusters of ectopics and skips) asymptomatic AFib attacks every second day. I spoke to the AFib nurse who was delighted with this result and said this would be considered controlled AFib as attacks of this sort would not remodel or damage the heart. I've learned to get comfortable with this and stop stressing which has additionally reduced the severity and frequency. Still going to go with an ablation when the time comes but getting on with life and being happy in the meantime.

Kenny

[Ppiman in reply to Kennyb1968]

Yes - same as me from the sounds of it. It must have been good to have the nurse so positive, They have such a wide experience so can be trusted. Depending how you feel, I wonder whether an ablation would be the best route?

My ablation was in 2019 for atrial flutter, but that seems to have uncovered these other arrhythmias including occasional but quite mild AF. It seems I might have had those for years but without knowing it was an arrhythmia, being put down to anxiety "attacks". Odd that!

I've been in two minds for a while now whether to pay for a private consultation to see if mine are still "benign" as the frequency is getting worse, but the Kardia shows them only as PVCs or as "NSR with Wide QRS" (I have LBBB, too). My GP isn't concerned, though and says it's common and something to live with. Luckily a bisoprolol tablet helps, but if I take it for more than a day, it brings its own uncomfortable side effects, I imagine by making my heart a bit too slow and unreactive. Still, reading what some have to deal with, I really shouldn't complain.

I hope you go on well. It would be nice to be free of all this, but I guess (in my case) it's getting older (69 this year).

Steve

[colin772]

As your heart rate is normally in the 40's I would be very wary of taking flecanaide daily as, from experience, it would lower your heart rate even more, and feel you would be better to have flecanaide as a pill in pocket treatment to take when your heart rate goes high.