Recently found out about AF but blood pressure has come down to the correct level and although an irregular heartbeat, pulse is within normal range....no medication taken yet. Would you be convinced the doc is right in diagnosing AF or should further tests be done?
Not convinced : Recently found out... - Atrial Fibrillati...
Not convinced
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Blueangelgate
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AF is diagnosed by ekg. If you're not sure your doctor is right, ask for the ekg and have it looked at by an electrophysiologist (ep) as they are the best at reading ekg's.
Jim
Hi,
If the diagnosis is from a family Dr. ( a GP), I would be wary. If it were from a cardiologist or an EP it would be correct.
How was AF diagnosed ?
It wasn't exactly....a 5min ECG by the doctor with a 5min follow up call the next day which consisted of a couple of questions about current lifestyle and diet and a brief comment about tablets. Wasn't until the following day when looking at the online medical records that it said AF diagnosed....
Then you’ll need to go back to your doctor to ask when and how the AF was diagnosed, whether it was caught on this ECG or a previous one.
Also, you don’t specify what the prescription was for. “Tablets” can mean anything.
With regard to BP, you don’t have to have high BP to have AF. I have low/low-normal BP and many others have BP in the normal range.
The only way for AF to be diagnosed is to capture it on an ECG. Some others have suggested a 24h ECG but if you have paroxysmal AF and it doesn’t occur at all in that 24h period, it doesn’t rule out AF. I had a 24h ECG recently and there was no AF, but it doesn’t change my diagnosis because it had already been captured by another ECG. If you’ve had one episode of AF, at any time, then you’ve got AF. Once you have that diagnosis there’s no reversal of it. Even if you only have episodes occasionally or rarely, regardless of how long the go on for.
A 24h ECG will record all of your ectopic beats within that period. If your heartbeat is irregular then you could be experiencing a lot of ectopics
AF doesn’t necessarily mean “tablets”. However, depending on age, gender and whether you have any other co morbidities, it may be advisable to take an anticoagulant. That’s because AF is a stroke risk. Other than that, medication depends on your symptoms and frequency.
What exactly is classed as an 'episode'? There are/haven't been any other symptoms. Just simply an constant irregular heartbeat
"Just simply a constant irregular heartbeat." Your words. Constant and irregular. Atrial Fibrillation usually starts with episodes - a few minutes or several hours of irregular heartbeat which normally stop naturally. All did for me, except the last one never stopped and now I have a constant irregular heartbeat. Mine doesn't have any symptoms, but if I have an ECG, or hear my heart, or take my pulse, it's always beating irregularly.
Paroxysmal Atrial Fibrillation is in episodes, the irregular beating can be felt, including a thumping feeling. I knew I was having an episode as I could feel it in my neck. AF is not life threatening, but does increase the chances of blood clots which cause strokes, so anti-coagulation is important, depending on age and other factors. There's a way of seeing if you should have anti-coagulation, called CHADsVAC. There's various treatments to improve your quality of life. I've had Atrial Fibrillation for about thirty years, I take daily anti-coagulation and get on with my life. In the past I've taken tablets, which helped, until my AF became constant.
Hello Thomas, is an irregular heart beat atrial fibrillation or can it just be an irregular heart beat. I am still not clear on this, although I have now had an irregular heart beat for 12 days usually never over 100 and if it has been over a few times its not much over and for 5 minutes . My blood pressure if lower or okay. Before this I would get irregular heart beat for a few hours here and there or maybe for a day or two. I am not clear on this. I can feel this. What do you do when you have this, ie do people exercise and drive around.
Can you get back to me. thanks a lot.
I have no medical qualifications, so I can't answer you . Blueangelgate has a prescription for abeta blocker and an anticoagulant and her doctor has seen 5 minutes of ECG. Sounds like AF to me, but I'm not medically qualified.
Some people don't like taking tablets. I don't mind if they work. My medical record has two warnings: No DOACS and No Betablockers, because of a very adverse reaction to Rvaroxaban, and rare side effects of Bisoprolol. I'm hapy to take Warfarin, and self-test and almost self-manage. My paroxysmal AF was treated with Flecainide, the last 3 year on the maximum dose (300mg a day), until I was found to be in persistent / now accepted as Permanent AF. For AF I take only an anticoagulant. See also Joy2the world's answer. There are nmany types of arrhythmias.
Hi
With me not true.
AF diagnosed with a stroke caused by undiagnosed thyroid papillary cancer. AF diagnosed as RAPID AND PERSISTENT.
No episodes, but I had uncontrollable sweating and I stopped during exertion, climbing stairs or mowinf lawns.
cheers JOY. 74. (NZ)
good post Thomas45 I to have same permanent AF do you still take any other medication other than a anticoagulant my GP just recently reduced my Digoxin
Thanks. No I just take an anticoagulant. My heart rate is around the high side of normal. I have a history of bad reactions to some tablets, including beta blockers and the new anticoagulants. In the past to two bisphosphonates, ( they help to strengthen bones if you have osteoponia or osteoporosis.), and bad reactions to 2 antibiotics, so unless my permanent AF gives me any trouble, and it doesn't, I will just take Warfarin. Within the medical group which runs my local medical centre and several others is a former GP who is now a specialist arrythmia doctor and he oversees my condition. He's very knowledgeable and has lectured on AF throughout the country, and is a trustee of the Atrial Fibrillation Association. I am no longer under the care of a hospital consultant. Hope all continues well with you.
An episode is what the word implies. It’s when you have AF for a period of time before your heart reverts back to its normal sinus rhythm. It can be for a few seconds, several minutes, an hour or two, or a day or two. It might happen every few months, every few weeks or every day.
An ‘irregular heartbeat’ doesn’t necessarily rule in or rule out AF. I have paroxysmal AF (episodes) but I also experience a lot of ectopic beats (not AF). Either can be described as an “irregular heartbeat”. There are many types of arrhythmia and the only way to find out what’s going on is to have an ECG, and even then it would have to be happening at the same time as the ECG. It’s very common for people to have a normal sinus rhythm on an ECG, and still have AF. It just wasn’t happening at the time.
As I said, you need to go back to your GP to find out when /if AF was found at any time on an ECG. It has nothing to do with BP or cholesterol or weight or how many steps you walk. You can still have AF. If you have that diagnosis, you can’t be undiagnosed.
Great, thanks
Consider asking doctor to wear a holter monitor or other medical device for an extended continuous period to determine the frequency/extent of any AFib episodes.
hi blue, you need it recorded on a ECG for a definite diagnosis.! Ask your doctor to give you a 24 /36 hour monitor to try and catch it. But chances are your heart will behave perfectly while you’re wearing the monitor.?? Soon as you hand it back and walk out of the door you’ll start with palpitations.?? That’s what happened to me for ages😡
I ended up going to A+E every time I had an episode and soon as they stuck the tabs on my chest my heart went back to normal.!! But one day they finally caught it👍
This is the thing. It was recorded on a 5min ECG. No mention of needing a monitor to follow up. Just a phone call to say yes blood pressure high and Irregular heartbeat, oh we can give you tablets for that if you want? It's either AF or it isn't....the tablets should be taken. Not, if you want them?? None of it was clear or discussed properly. Blood pressure has now come down due to changing the diet and pulse still in range but irregular. It's been like it since early 20s when it was checked then and got told it was nothing to worry about
I know doctors are the professionals and we take what they say but as far I am aware AFIB can only be properly diagnosed once a ECG has been looked at/studied.!( I maybe wrong as I’m not a physician) personally I would not accept I had AFIB without it being caught on a ECG and looked at by a cardiologist. I bought a kardia device for around £100 and its brilliant. Iv caught my episodes on it and showed it to my cardiologist in the past. It was him who told me which one to buy as it’s recognised by the NHS.👍
Having Afib now doesn't mean your arrythmia when you were in your 20's was Afib. It might have been ectopic heartbeat, which is normally harmless and Afib came on later in life.
The challenge with getting diagnosed with Afib when you have paroxysmal AF is getting an ECG done when you are having an episode. However, if your arrythmia when you were in your 20's was persistent or permanent then Afib should have been easy to diagnose. I therefore doubt it was Afib - as can't see anyone saying a diagnosis of Afib is "nothing to worry about", even when you're on your 20's.
Exactly. I had ectopic beats for about 10 years before I had my first AF episode. They both can be described as an irregular heartbeat but they are two entirely different things.
Next step private appointment with an experienced cardiologist.
Did the doctor advise you about the way forward? I'd be surprised if he/she didn't. Doing nothing is not really an option - at least not until you've had any tests needed to inform decision-making.
I have paroxysmal Afib i.e. comes and goes. For me it was infrequent episodes usually lasting 12-14 hours). A fairly low Afib burden but I was still sent off for tests to check out my heart, calcium score etc - all of which, assisted my cardiologist in determining what he believes is the best way to manage my Afib.
No advise from the doctor, no follow ups or referrals. Just a prescription for tablets.
Sounds like you need a better doctor and a referral to a cardiologist. What medication is your prescription for?
2.5mg of bisoprolol and 60mg edoxaban but when the doctor mentioned meds she was only referring to one for high blood pressure so you can imagine the suprise when the prescription was collected it contained the above
I'd be asking for a referral to a specialist....
That's my thoughts
How are you getting on with your medication. I have the same ones.
Will keep you posted, it's not me it's my dad
It sounds like the diagnosis may well be valid. You say that your GP gave you an ECG for 5 minutes. If you were in afib during this period it would be evident on the reading and hence support the diagnosis. The subsequent questions the following day may be to clarify if other factors/correlates are in play. An EKG might be helpful to see if there is any structural damage to the heart.Rate control and anticoagulation is the standard treatment for most patients.
My cardiologist had ECG showing Afib but sent me for CT Coronary Angiogram to ensure no structural heart problems, sign of previous heart attack etc. So ECG not definitive enough on its own, especially if planning to prescribe flecainide - contraindicated for people with structural heart disease or had heart attack (in previous 2 years?). In most cases, you'd know whether you've had a heart attack previously but not always.
Fair comment.
If the ECG was done while you were in AF then the diagnosis is fairly obvious. Standard ECGs are for 10 seconds btw.The shape of the heartbeat is different under AF than NSR, it's not just the altering rate which gives it away
The underlying rate is not indicative either, that is, your rate may be within bounds, but still in AF.
It may be that when your irregular beat was picked up in your twenties that because the risk of consequences was very low (stroke) you were told it was nothing to worry about.
My surgery puts my ECG graphs on my NHS app. Surgeries differ of course but presume yours doesn't from what you say, but you can ask for a copy.
You can get your medical records on a NHS app? Across UK do you know?
Yes, there is an NHS app. Download it, identify yourself with the usual rigmarole (plus your health service number) and take a look.This is not the track and trace app,but it will allow you to see your COVID Vax details ( so maybe you already have it?).
You have a legal right to see all of your health service info, so my surgery put everything on it, test results, letters blah blah. Mine has info going back years. They've just put a brief summary of my 'Lloyd George envelope ' on ( I had to Google it!). So now has notes of my childhood vaccinations (I'm 60)
My phone is android, but I assume if you have a cr*pple phone there's one on istore 
Brilliant Omniscient 1. I will get on it today. Hopefully is cr*apple iPhone friendly🤞😵💫
My phone is android and I have the NHS app, and the Airmid app.
Yes the airmid app does more things, and interprets the info a bit more. I'd try them both gtkelly .
Have checked but unsurprisingly we cannot access in N Ireland. Too much to expect. After all this is only the 21st century 😵💫
Deep gloom. Have you tried the airmid app?
Just tried. Same result. Data from
N Ireland patients cannot be accessed.
Meanwhile back in the dark ages….
personally I would not accept any serious diagnosis ( or lack thereof ) from a GP ( usually haven’t got a clue about ecgs apart from there is something abnormal ) without corroboration from a relevant consultant . I agree. A one off consultation with a private EP is the way to go . Just look at the profiles of the cardiologists at your local private hospital and it will tell you who has a special interest
If the AF wasn't directly shown on an ECG, then you might have had runs of ectopic beats, but, in my experience, these don't cause such a racing heart as AF can.
In the UK at least, you don't need an EP to check an ECG as all cardiologists are identically trained in that respect; indeed, I would suggest this is the case worldwide. In the US, it seems that the private system tends to favour that EPs specialise more in arrhythmias than elsewhere.
Steve
Yes, ECG a must, my GP does that and then decides whether to refer me to hospital cardiology.
ECG done. No mention of a referral or follow up once medication has started. Would you insist on a follow up/second opinion?
hi, my understanding from my GP is heart medication, eg beta blockers, edoxoban is usually decided by hospital cardio consultant, So I would expect referral to consultant and regular, annual check ups. Even my recent weaning off Bisoprolol was decided by consultant.
That's what I thought. Just not happy taking medication for something that hasn't been discussed properly. Thanks 🙂
Hi, have a look at NICE guidlines for AFib, they say what should be done but not by who. But, some of things it is certainly unlikely GPs would have equipment and they would have to be done in hospital. Ask your GP when you will be referred to a cardiologist.
For me (in the US) the next step was an echocardiogram (ultrasound of the beating heart, easy & painless) to be sure there were no structural defects or problems in my heart. I was confirmed with paroxysmal atrial fib 16 years ago! and am on metoprolol (similar to bisoprolol in certain ways). I also take 150 mg flecainide if I have an AF episode--which for me is triggered (maybe every 2-5 weeks) by not enough sleep, anxiety, and sometimes wrong food/overeating. Flecainide stops the episode after 2 - 5 hrs. (I see a regular cardiologist and an EP (electrophysiologist) at intervals.)
Some AF'ers prefer to get along on meds, and some eventually seek ablations, which may or may not work depending on many things. Once you get a few more details about your condition, you will find more clarity in how best to manage it. We usually start w/ the meds and see where it goes from there. Blessings for good heart health... Diane
Hi
One can have AF in high BP or normal to low bP.
Same as AF in rapid H/R or normal to low H/R.
AF simply means IRREGULAR HEART BEAT.
But there is a risk when the heart is irregular of blood clots circulating about yor blood stream.
I would think that you will be considered for DOACs.
My undiagnosed Thyroid Papilliary Cancer caused AF which in turn caused STROKE embolic type.
You don't want that.
Some folks live with irregular heart beat. My stroke happened at night when I have a H/R avge of 47.
Take care, JOY. 74. (NZ)
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