any ideas?

[Janau]

hi my husband has paroxysmal a fib last 4 years. Doesn’t know when he has them thankfully. Takes digoxin and Rivaoxaban. He was given a dual lead pacemaker in January as his bpm kept going below 50. He fell and broke his nose due to this. He had another fall a few weeks after and hit his head.,pacemaker fine. No cause found. Two weeks ago he blacked out for a few seconds again no cause found.He occasionally gets lightheaded/dizzy spells. Bloods urine pmaker ecg all fine. Not in a fib at the time. They reduced digoxin by half and sent him away! He had an echo scan before his pacemaker was fitted. All ok. In his last pmaker check they altered a few settings which did make him feel a bit better. They said he had 400 odd SVT’s (did they mean a fib?) (I have SVT so I know what that means!). Anyway my question is this: he is 77 and still quite fit the a fib only lasts maybe 24 hours at most (used to be up to 6 days a few years ago) but the last few months he cannot do as much as he used to. He walks for 45 mins every morning (not too fast normal pace) and 2 /3times a week another 45 mins in the afternoon. But if he does that he has a good hours sleep when he comes back. I know he’s not in the first flush of youth but he just doesn’t have the energy he did this time last year. He doesn’t smoke/drink not overweight. He used to do a lot of gardening now he has lost all interest in it. He’s given up driving die to the dizzy spells. Do you think maybe an ablation would help? If he could get one that is. Many thanks and sorry for the rambling post! 😊

[Hidden]

I appreciate that you are only seeking opinions Janau, but given your husband’s overall position, the only safe and sensible thing to do is seek the advice of an Electrophysiologist who as I’m sure you are aware, is Cardiologist who specialises in Arrhythmias. Obviously he has had specialist advice in the past, but if it’s possible, perhaps a private consultation would be the quickest way to get the medical help you both need right now…..

[mjames1]

" he just doesn’t have the energy he did this time last year....Do you think maybe an ablation would help? "

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This will require some detective work both on your part and your doctors. Has his afib burden increased significantly in the last year? When did he start losing energy in terms of the Pacemaker being implanted? Was he on digoxin last year? Any other medications added? If so, maybe discuss with your doctor a trial off of it as medications can sometimes sap our energy more than even afib.

Ablation has a decent success rate in eliminating or reducing the afib burden, but unclear if the afib alone is what's causing your husband's energy decline.

Jim

[Buffafly]

The same thing happened to my husband (minus the dizzy spells). It is always tempting to blame symptoms on AF but I would want your doctor to look elsewhere just in case. But the SVTs could be short fast runs however they should coordinate with the blackouts if that is the problem. Please ask your doctor to think outside the box. Maybe an abdo scan for aneurysm for a start…..

[Janau in reply to Buffafly]

hi thanks for your reply. Did they find out what was causing your husbands issues? Yes I agree I think they see AF and just blame that. When they downloaded the data from his pacemaker there was nothing unusual on it at the time it happened. He had a full body MRI 3 years ago when these dizzy spells first happened. That’s how they found the AF as he didn’t know he had it so it was lucky they did.It found something on his liver(sorry can’t remember the medical term I have a letter somewhere) it turned out he had sort of cyst like growths that were totally harmless but an unusual type. They said forget about it. He also had a full abdominal scan after that to make sure too. Nothing else was found thankfully. I don’t think there’s anything else left to look at!! The only thing mentioned that it could be is Ménière’s disease as he’s deaf in just one ear. He certainly a puzzle 😊

[Buffafly in reply to Janau]

Ménière’s disease is very debilitating - my friend’s husband suffers from it and it’s affected his QOL considerably. I had some balance issues recently and it certainly does put you off doing active things. As you say all those tests should be reassuring but frustrating that they don’t show anything helpful.

My husband was eventually found to have cancer and two aneurysms and that didn’t end well so it’s good to know your husband has been thoroughly investigated.

Best wishes ❤️‍🩹

[Janau in reply to Buffafly]

Oh I’m so sorry about your husband sending you best wishes ❤️‍🩹

[Tapanac]

My husband had to have a pacemaker because he kept getting dizzy light headed spells snd passing out. Kept having checks but couldn’t find the reason, but on the last occasion of passing out I quickly got the BP pulse monitor and his heart rate was 30. So emergency pacemaker

Then he had one or two light headed sessions again and they had changed the pacemaker before he left hospital from 60 to 80 bpm without telling us

This week he had to have another check in pacing snd they changed it back to 70 he feels much better snd thoughts are that after 30 bpm it might have been a bit of a shock to his system going from 30 to 80

All the best to your husband

[Janau in reply to Tapanac]

Yes sounds familiar. Same story with mine! His pacemaker is set at 60. They checked it and the time he felt weird but nothing showed up on it. It’s all good fun isn’t it 🤨thanks for replying and best wishes to you both too 😊

[2learn]

Hi, I'm 75 and miss exercise as it was always part of my life, I've raised with GP issues of tiredness and response was I was an old man what did I expect. Thanks a lot, raised with consultant who took me off bisoprolol, made no difference. I'd think dizziness and falls need investigation, has he been checked out for a TIA or vertigo.

[Janau in reply to 2learn]

Hi I know I get the impression that they write everything down due to age. Not good. I keep mentioning TIA every time he ends up in A&E but they say no. He has a head CT scan each time as he is on thinners nothing is flagged up. Bisoprolol didn’t suit him same as you. Like you I think I’m sticking with vertigo. My friend has vertigo and the very first time he had a ‘turn’ she said that sounds exactly like my vertigo. Thanks for your reply 😊

[2learn in reply to Janau]

Hi, I was advised years ago by GP that sea sick tablets can work for vertigo, and its worked for me in the past. Good luck.

[Janau in reply to 2learn]

Hi! Funny enough one of my friends husband has labryntitis and he takes those if he gets a bit wobbly. Think that’s worth a try. Thanks! 😊