He's had 4 episodes but each of the first 3 had to be cardioverted to restore NSR. He's still in the 4th episode and this is day 4. It's been 11 months since his last episode.
In his previous episodes, his hr has been elevated as expected. This time, his hr is pretty much staying in the normal range.
He has a cardiology appt tomorrow (we're in the US), but I was curious if anyone else has any thought on why his hr is staying normal (resting in the 60's) this time and if that was a good sign, a bad sign, or no sign at all.
Also we've tried so many self conversion techniques of the years and had no luck. Any thoughts on self conversion with a lower/normal hr? And whether he might be more likely to self convert with his hr normal?
Thanks to all you brilliant, caring people for sharing your experiences.
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SouthernChelle
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I have has PAF and AF for years, I can only give you my experience - I have had a HR of 60 or lower and been in AF.
I also have bradycardia and have had heart rate as low as 32.
I was hospitalized with VT and collapsed in bed I was brought round and given Amiodarone for VT but now I have Amiodarone for AF plus a blood thinner Riveroxiban
I have never been cardioverted but must have been for VT (ventricular tachycardia)
One thing - You don't mention your husband being on any medications for AF?
Your question AF and NHR - Well I have a lower heart rate than would be expected with AF - Might your husband have just been having an irregular heart beat rather than AF when HIS HR was 60.
He's definitely in afib. We have a kardia mobile. And he was checked out in the ER 2 days ago.
He takes nothing for afib except Eliquis. He is also on a bp medication. Valsartan. He has gone as much as a year and a half between episodes and as little as 6 months. The first time he was in afib at least 6 months before he was cardioverted. And that was done because he finally got an echo and his ejection fraction was in the 20's.
With all the previous episodes of afib, his heart rate was high. Probably around 140's average. This time his heart rate is rarely over 100, and that is when he is moving about. His resting hr is in the 60's. Which is normal for him when he's NOT in afib, but much lower than his other afib episodes.
He's very fit. He exercises daily. He walks. He eats very healthy.
I'm sorry you've had to deal with all of this. But again, really appreciate your insight.
The fact he is "very fit" will help to keep his heart rate down. Eliquis also known as Apixaban is an anticoagulant medication - Not unlike the Riveroxiban I take.
You say this time his heart rate " rarely over 100," He is doing all the right things, keeping fit really does help.
No need to say sorry at all - was glad to share my experience if there was a chance it would help the worry .
My HR in afib is usually in the 70s , but my normal is 60s. I get episodes every few weeks. I'm only a little symptomatic. My episodes self-terminate after a few hours, either with exercise or sleep. I also have a fair number of ectopics, which may help the afib terminate, by pausing the heart long enough for NSR to resume? Try tensing/ exercising, deep breathing then breathe out as you lie down suddenly so your heart pauses a bit and take a big deep breath? I used to have faster afib, maybe you're just more relaxed now? I am, more relaxed about it now.
My husband isn't very symptomatic either. He doesn't actually feel the arrhythmia, but he gets short of breath. This has also been better this time with the lower heart rate. That's a very interesting thought about him being more relaxed about it. You wouldn't have a youtube video or something showing that exercise/lie down technique would you? Thank you so much for sharing your experience.
Hi, I started with AF in 2001. At first episodes were fast HR ,160 plus ,lasting up to 48 hours, always self converted since first episode when given Digoxin. Over the years episodes have become much less frequent and puzzlingly HR stays between 70 to 80. And now usually only last 4 to 8 hours. I take Eliquis, BP med and thyroxine. I have propa fenone as a PIP but prefer to sit it out. In comparison to the early days I can cope with this . I'm not sure why my episodes have changed in nature , the only change has been to cut out alcohol completely. Sadly I can't help with why it has changed and I havent seen any heart medic since 2016. I do hope you get some answers. Best wishes .Kath
Very interesting! Maybe for some it just does get slower over time, perhaps as @whats said earlier, as it's not as startling to the system? It's a great comfort to know that others have experienced the same thing. We would love it if we could get him to self-convert. I'm not certain, but here in the states I don't think they offer the PIP as readily? He has also cut out alcohol completely since the first episode. Thank you so much for your comforting words and thoughts.
Hi I am soon to be 60 and in Atlanta, GA. I had an ablation six years ago that kept the Afib under control. However, I have been having episodes over the past six months that are increasing. So I am scheduled for my second ablation at the end of next month. As your husband, I have noticed that my episodes are different this time, and that my heart rate is staying pretty much in normal range. This was not the case six years ago before I had the ablation. My heart rate was much much higher. I’m going in and out of a fib about every three days and the episodes are lasting anywhere from 10 mins to 2 days. I strongly suggest for your husband to consider an ablation with an experienced electro physicist. My electro physicist is sought after, and considered the best in the south. Your husband doesn’t need to be living like this and is young enough to do something about it. To answer your question, I do not know if it is a good thing or a bad thing about the heart rate, but I just wanted to let you know I am experiencing the same.
We live close! We're close to Chattanooga, TN! My husband and I talked, on the way home from his cardiology appt today, about how he fears ablation (his mother had a terrible time with an ablation with someone local that contributed, we believe, to her demise). He did say that if it came down to it, he would rather travel. If you don't mind sharing your Dr., we would be most grateful! And thank you for sharing your story!
Hi SouthernChelle!! Dr. David Delurgio at 5671 Peachtree Dunwoody Rd Fl 3, Atlanta, GA 30342. He is with Emory Heart and Vascular and offers tele-visits. He is the best of the best, has done thousands of ablations, and specializes in complicated cases. If you google him, information and videos are abundant. When I tell you I did my research on him, that is an understatement. I was terrified going in to have the ablation, so I understand how your husband feels. I am sure his fears are even more so than mine because of what happened to his Mom Dr. Delurgio told me before the first ablation 6 years ago that it might take more than one, and I have been essentially symptom-free until about 6 months ago. I am scheduled for my second one at the end of next month. I am not anxious this time because I know I am in good hands. Please let me know if I can help you in any way. Robin☺️
Thank you so, so much! I told my husband about your comment and he was very grateful to get a recommendation. I wish you the very best and look forward to hearing your victory update in a few weeks!
have had 3 cv’s over last 4 years. Most recent 5 weeks ago. All successfully restoring me to nsr.
From various posts and replies that I’ve read on this forum I believed that when in arrhythmia no accurate hr can be established. The heart beat is out of rhythm?
Just to clarify, even though the heartbeat is out of rhythm w/ AF, we can still count the beats accurately enough (on wrist or gently on side of neck) if the overall beat is slow enough, which mine always is in afib (65 - 90). I have not been cardioverted because flecainide stops it in 1 - 4 hrs, so I'm used to taking my HR when in AF. (What doesn't work well in AF is the pulse ox device.) Cheers, Diane S.
That's a good question. After the first two vaccinations in 2020, I received a mild arrhythmia. The cardiologist prescribed Metoprolol 25 mg. After the boost shot in 2021, severe AF began, I had a cardio-version.
Hi SouthernChelle, I'm also in the southern US (Kentucky and Florida); I'm so sorry your husband is having to deal with AF, but fortunately his episodes are few and far between. You asked at one point about PIP in the south. Every one of my cardiologists including the electrophysiologist (EP), plus my GP, believe in PIP, and that most people should be started out that way, to see if it works for them. So, for the last 4 years, I've been using 150 mg of flecainide PIP to end all of my episodes within 1-4 hours. Thus, I've never needed to be cardioverted. My episodes are also in the 60's to 80's range (normal HR), and my drs. said "that's a good thing", as it implies lower stroke risk.
Re self-conversion techniques, I've also tried it all. What has worked? Singing, doing slow breathing (check out internet for that), listening to my own recorded therapeutic harp music, walking slowly for 30 min., humming, using "Tapping" (EFT--see internet for simple technique), sleeping on the right side, and drinking Mg & potassium electrolyte liquids. Eating small meals & stopping by 6:30 pm helps me tremendously. Your husband can probably add a lot to my list! The issue is always, triggers vary, so none of these methods work all of the time--except for PIP flecainide. (Some here have had negative side effects, but these are usually dosage related. Flec has been a miracle drug for so many, and is safe and effective esp. if you start with PIP since it isn't a daily dose.)
As for ablation, if it's been almost a year between episodes, I am one who prefers to try the least invasive methods first, since ablation works for some, not for others, has its own risks, very often requires 2-3 more ablations, and you still have to take anti-coagulants & maybe meds indefinitely. Some of us are living well with PIP meds, maybe a beta blocker or calcium channel blocker, etc., and awaiting newer, safer, hopefully better methods which might include mini-maze, convergent, and other options coming down the pipeline. Hope this helps a bit, I know it's a lot to sort out! Wishing your husband all the best in his journey. "All shall be well" for him. Cheers, Diane S.
Wow, thank you so much for all the info! He had his appt with the cardiologist this afternoon who told him since the episodes are so far apart, that he would feel better about doing the cardioversion vs PIP at the moment. He did, however, say that should the episodes come closer together, that he would prescribe Flec and see if that worked for him. The cardiologist said that he'd have to spend 24 hours in the hospital after the first dose to make sure he didn't go into a lethal cardiac rhythm, and I believe I've heard that said before. Was that your experience with Flec?
You probably travel through my town of Chattanooga on your way from KY to FL. So very nice to see some folks who are "local-ish"
Since I can't figure out how to edit my post, I wanted to add this here. Late last night one of our very good friends was staying in his camper van in our business parking lot helping with security. The lot is heavily secured/fenced and has cameras/alarms. We got a call around 10:30pm from our friend asking for help. He couldn't breath. I called 911 while my husband jumped in the car and headed toward him. I told EMS to please get in however they needed and to bring bolt cutters as he couldn't make it to the gate due to his lack of breath!
They got there in the nick of time, as he was lying in the parking lot all but unconscious. Long story shorter, he had 2 completely blocked arteries (LAD and circumflex). They stented the circumflex but the LAD was an old occlusion with collateral blood flow so they are deciding what to do about that after more tests.
He spend the night in CICU. Visited him this afternoon and it's as if nothing at all happened to him. From the time of his call to us, until he was in the cardiac cath lab was under 2 hours.
I am so, so grateful he's okay. Watching him on the security cameras, it looked like it could have gone a different way really easily.
I say all of this because I wanted to explain why I didn't respond as timely today. Between being up all night and my husbands cardiology appt today, it's been hectic.
I really do value all the insights. Thank you all so much.
Hi Chelle, Yes, I frequently come through Chattanooga & will give you a wave next time! We're not much more than 3+ hours apart. Actually, I was given flec PIP by my former cardiologist at his office, and no hospital stay was required. This surprised me, he's a very experienced dr., but I had no side effects & 4 yrs later, still no problems. I just take the lowest dose that I've learned always converts me (150 mg., and on rare occasion I may take another 50 mg if I want to convert more quickly--but never the max dose which is 300 mg within 24 hrs). I think keeping at half the max dose has been very safe for me. I am a bit surprised at the dr. preferring the more invasive cardioversion. How does your husband feel about that? I think we who use PIP love the ease of it, can take it in the middle of the night or any time, and stay home resting w/ tea and a book or sleep for a few hrs. But let's hope he doesn't have any more episodes for a very long time! All good wishes, Diane
I'm with you! I think the PIP would be so much easier/better, and definitely worth a shot!
My husband isn't convinced that it would convert him because when he was first formally diagnosed with afib in the ER they gave him some IV meds (he doesn't remember which meds, but it wasn't flec because it seems to be protocol to keep people here for 24 hours when given flec). And he was home in about 4 hours.
The thing about that time that I think might be different from now, is that he had most likely been in afib for 6 months or so at least. I'm under the impression that the sooner you catch it, the more likely you are to convert?
I'll be waving back when you pass through! Thanks again for sharing! It really does give me hope that we might be able to handle this at home some day.
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Dr. Delurgio told me before the first ablation 6 years ago that it might take more than one, and I have been essentially symptom-free until about 6 months ago. I am scheduled for my second one at the end of next month. I am not anxious this time because I know I am in good hands. Please let me know if I can help you in any way. Robin☺️
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