Hello, very grateful for any advice please regarding Pre syncope and AF. I have put up with PAF for around 6 years and take the usual medication Flecainide, Apixaban, Bisoprolol, also take Ramipril & Atorvastatin. Also take Zapain for arthritic knees. Worryingly during the last 3 months I have had increasing episodes of Pre syncope. I’ve been listed for an RF Ablation next Mon 3 Oct. I understand without more info its difficult to answer but my question is what is the association between AF & Pre syncope? (I’ve never passed out) I still work full time and tbh I’m worried enough with the thought of ablation but these pre syncope episodes have me quite concerned. I realise this is a convo with my Dr but I’ve come to respect the opinions & shared experiences of this forum and wonder if anyone else has suffered with this & would the ablation eventually (understand blanking period) resolve the syncope issue or is there usually another underlying cause ?.
Many thanks ☺️
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Presyncope is usually a result of one of a number of things. It can be sudden drops in blood pressure (sometimes due to lack of good hydration so drink plenty of water) or it could be due to short pauses in heart beat which sometimes occur when going from AF to NSR. It can also be a result of extreme bradycardia or even heart block so the short answer is who knows? A holter monitor may tell what is what if worn long enough but we all know how such things often hide whilst we wear a monitor.
I do hope that you have read our two fact sheets on preparing for and recovering from ablation which I will happily sign post for you if you have not.
Many thanks Bob I do get sudden drop in BP (must drink more for sure) pulse has gone as low as 41 but usually early / mid fifties when Presyncope happens. I was given copy of the AF Association fact sheet re ablation during pre op assessment and a reassuring chat with the arrythmia nurse. Grateful for the reply👍
I had that problem - given choice between pacemaker and ablation, chose ablation and my HR seemed to remain a bit higher than before afterwards. The ablation lasted for two years but I haven’t had presyncope as bad as I had before. I would check your BP at home as I was having ‘funny turns’ and found I didn’t need extra BP meds.
I used to suffer with pre syncope before reverting to NRS as my heart rate dropped too low. On one occasion I passed out and so was given a pacemaker and have had no further problems.
I had that snd the pills I was taking for afib tachycardia were lowering my heart rate too low hence almost completely passing out
Had a pacemaker snd now can take pills to keep afib tachycardia at bay. They were going to do ablation first, but no guarantee that I wouldn’t have to take pills afterwards. Now if pills keep me on track (low dose) then I won’t have to have an ablation st Harefield which was a complicated one and as I’m nearly 80 this way was the lesser risk as I do have other heart complications
A pacemaker sorted my pre syncope as during any AF episode I would come over all feint and faraway several times but never actually passing out. I could have lost my driving license if it Wasn't sorted as you are supposed to declare it to DVLA I believe.
Hi Rosemaryb1349, AF is an unpleasant thing to have. I have pre-syncope with my episodes, sometimes quite mild but on my last AF episode I had it extremely badly and also had this feeling of being ‘far away’ as if I was in a bubble and detached from the world. It was frightening as I’ve never had that before. Hope you’re okay now.
I can understand your concern. I’ve had PAF for 15 years, using 200mg Flecainide as a pill in the pocket. Never used to have any episodes of syncope or pre syncope. But suddenly this year, it’s all changed. Episodes are coming much more frequently and after I take my Flecainide sometimes my heart rate drops dangerously low and I either faint or feel as if I’m about to. It’s a horrible feeling. In July I was blue lighted to hospital after passing out in a restaurant. The lovely paramedics said my HR was 30-40bpm and insisted on taking me in. I’m down for an ablation next spring, and meanwhile I’m trialling cutting down my Flecainide PIP dose to just 100mg now, which seems to work just as well. I still sometimes feel faint, but I’m careful and make sure to lie down for a few hours after taking it. I have been on 1.25mg Bisoprolol daily for years, and do wonder if this is now contributing to lowering my heart rate too much. Nobody’s ever managed to explain to me what Bisoprolol is actually for!
I had AF for about 5 years before I started getting near faints (pre syncope) and then blackouts (Syncope) that on analysis of my Implanted Loop Recorder turned out to be heart stoppages of up to 14 seconds. The worst episode was precipitated by a change to Flecainide and I was promptly hauled off to A&E. I would be inclined to challenge the use of Flecainide as your problem sounds as though it may be brachycardia rather than tachycardia that Flecainide is usually associated with. You should not give undue weight to my anecdotal opinion but should seek expert advice soon. My problem was sorted out permanently with a Pacemaker. I never had ablations or cardioversions.
thanks so much for your reply, Quanglewangle. I love your choice of name. I should have gone for Scroobious Pip myself. I think you’re right about the Flecainide. It used to work a treat to bring down a rapid HB but suddenly this year I seem to have the opposite problem. It’s nigh-on impossible to speak to my GP, and anyway he more or less admitted he feels out of his depth on this. He did refer me to cardiology back in March, but I’ve heard literally nothing back. I only got my NHS ablation appointment by seeing the EP privately. Think I’m going to try ringing his NHS secretary to see if it’s possibly to talk to him, or someone, about my medication, as the op is still a long way away.
Hi my husband gets the same yes. He’s had a fib for 4 years. Normally lasts about 24 hours every other week. No triggers we’ve tried everything! He has no symptoms when in AF. He has episodes of light headedness(that’s how the af was actually caught in the first place) that comes out of nowhere. Last January he blacked out and broke his nose. His bpm was all over the place in the 30s then in the 130’s! He was given a pacemaker. It does not seem to have stopped the episodes but they are not as frequent. He’s had three ‘good’ ones ending up in A&E with bangs to his head. Last one was last tues in marks and Spencer’s buying socks! Didn’t hurt himself thankfully just wrecked the sock display! He’s had every test they can give. All comes back normal. And it happens when he is in NSR. He takes Rivaoxaban and digoxin. They have halved the dose of digoxin and halved it again last week to 62.5. See how we go. He doesn’t lose concouisness just can’t stay upright with light headedness. They check his pacemaker to see what it was doing at the time of his ‘turn’ but nothing shows up. They assume it is a drop in BP but again when they test him it’s normal. He’s a mystery. But a worrying mystery as I worry when he’s on his own. He’s nearly 78 but is fit and healthy and walks every day feels fine most of the time. We did think the pacemaker would solve it but evidently not.
Thanks Janau .. I'm hoping in time to find out reason for the light headedness it is a mystery .. I wish your husband well and hope he has sufficiently recovered from his trip to Marks & Sparks & they let him back in!..
The first event of afib that I had was a full black out. I’m not even sure why I was out of bed but I woke face down on my concrete floor. We won’t even talk about what it did to my teeth and I am still unable to get them removed at this time. Yes the top ones are where they don’t belong now and must be removed. Because of things that of happened and the fact that I am still healing from my pacemaker, etc. my doctor said not to consider getting anything done except emergency medical until after the first of the year if all goes well. He said my body and I have had enough. I blacked out twice that night by the way, not even realizing that I was still up and trying to walk. I thought I had gone to bed.
With me it was a blood pressure drop, as well as the fact that I had tachycardia among other things one thing I can no longer handle is hot weather I love the heat, but it does not love me any longer even know if I step out on the porch when it is warm it is as though I am being suffocated. We recently had temperatures of about 110° here in Texas for several months straight. The only time I left the house was when I had to such as a doctor appointment.
I’m sorry he is still having these type of events with the pacemaker that doesn’t sound right but I am not his EP. I also have heart failure but since the pacemaker I do not get lightheaded etc. which at one time happened far too often.The feeling of being in a bubble is some thing I’m also aware of.
Yes, unfortunately as I learned having the pacemaker will not stop you from having the events so you do feel them. It is just that they can no longer damage your heart. In fact, my heart failure has actually improved somewhat, which my doctor had hoped to have happened, but there was no guarantee. My afib is gone, but my flutter is still with me. It’s like being married to it I guess until death do we part but at least now my heart is in charge not the flutter and not a fib
Healing, thoughts and prayers for your husband. I hope they get him some answers because the danger in blacking out is hitting something when you go down.
Oh you poor dear! I hope you get some relief from the heat soon but I guess in Texas it’s never going to be that cold! Yes he is the same loves the heat but I don’t let him sit out for long now as it can start up his a fib. Same in the very cold weather. I guess it’s the heart working overtime to compensate. Thank you and same to you. X
Thank you for your kind words. Oh, it does get cold here but I’m originally from New England so I may not like the cold, but I am familiar with it. Living in Florida for more than 20+ years though I have become spoiled. If we have our pool next summer, I’ll be OK lol as I said, I love the heat it just does not like me. Texas is so big you have all kinds of weather.
I’m not a fan of the cold! But I don’t like it too hot either 😃 we’ve been to Texas 20 years ago (time flies) we went to Houston Dallas and Fort Worth. We were on a drive from a Orlando through Alabama New Orleans into Texas and back again. Love Florida used to go a lot some really beautiful places and I loved The Keys. I think my favourite of all the cities we did was Savannah and Charleston. I would love to live in Charleston in one of the historic homes. Ah one can dream
I lived in several parts of Florida. I’ve only been in Texas two years now. My favorite is South Florida on the East Coast but it has become congested and very unkind. They are taking the beauty away from old Florida sadly. The Orlando area was my least favorite because of the weather. It is the worst humidity I ever felt. I would walk out my door, and by the time I got to my car, I would be wet it was as if rain clouds hung around your body lol not pleasant at all. I was up in the panhandle also Panama City, it was OK. I am just not into the gulf, again because of the weather. I don’t like that body of water either as it produces horrible weather. The water itself is always a bit dirty looking although when you look from the beach, it looks emerald green and gorgeous I am in southeast outside of Houston and it is gorgeous. We did have over three months of hundred degree plus weather nonstop. Without rain which can be tough but it is so pretty here and the people are nice 🤗😊
PS it has finally gotten chilly here lol it was 91 today. On a serious note it does get cold here at least to me. It is cold after living in Florida about 25 years but I am a New England girl by birth. I can handle the bad weather and cold I just don’t like it lol. The bad thing about the hot weather now is that my body does not seem to like it. I always said I liked 100° plus especially if our pool was in. Now if I step out the door on one of those hot days, it takes my breath away. It’s so not fair because I love the feel of it but I have found breathing to be a necessity lol
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