I am new here, so bear with me!!...Diagnosed with AF 2 years ago ( HR 146, reduced to below 100 on treatment ) in A&E here in the UK. I was an active runner ( 5-10K races ) with a RHR of about 52. I am 68 , and I have hardly any symptoms. I had an ablation in the May ( this year ) which put me in NSR for about a week, but now back in AFib.
My issue is I am sure that this is going to turn into Persistent AF. I have been listed for a cardioversion next but my real worry is my heart rate and I wonder what others here think or if you have had similar experiences. My echo showed a slightly reduced ejection fraction 45-50%, but considering I was in AF when it was done then that is not surprising. My latest 24 Hr halter monitor showed periods of tachycardia and an average HR of 90 BPM. I was on bisoprolol 5mg but now on 7.5mg, its just been upped.
My biggest fear is not a stroke, ( I am on Edoxaban ) but developing heart failure. I am obsessive about my heartrate and its not helping.. Questions,... what can be done about tachycardia.? I know mine is probably at the upper limit of average but what are the options to reduce HR, and am I panicing too much??
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FSsimmer
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Yes. Normal HR is between 60 and 100 so an average of 90 is not that high particularly when you know that ablation often increases RHR to between 80- and 90 and can take a year to return to normal.
Your ejection fraction is actually quite a bit down IMHO and whilst it does tend to drop with age mine in February was 55-60 and down from the previous in 2019 of 60-65%. I have yet to recieve the report for the one done last Thursday.
Sadly your athletic history does make you a prime candidate for AF as I am sure you already know.
Thanks very much for your response. I was told because I was in AFib the EF would drop. I will just carry on with the tabs and go for my cardioversion. My Echo was not any different from the one I had at initial diagnosis I believe
I don't understand your humble negative opinion re FSsimmer 's ejection fraction. Is your opinion taking account of the fact he was in AF during the measurement?
Your reply has confused my thinking, and further clarification would help.
To add a bit, I've had two Echos in recent years, in Oct 2020 aged 77 which gave an EF of 68% and again in Nov 2022 aged 79 an EF of 65.2%.
However, it is I feel unwise to look at an EF reading in isolation ( just a set of numbers) WITHOUT reading the rest of the Echo Report and comments by the person conducting the Echo and signing off on it.
In my case my AF is totally controlled and I was not in AF when these Echos were undertaken. However there were many other aspects of these two Echos which suggested that the condition of my heart had deteriorated even though there was only a minor deterioration of the EF.
When I discussed the two with my GP she commented .... not serious .. just consistent with age. Of course she has access to all my detailled medical history including those arising from my annual Surgery inspired medical reviews.
To add a bit of my own, I am very disappointed the Volunteer BobD couldn't find time to Reply to my direct query to him for clarification of his comments.
Hi! I am of similar age (71) and with similar resting HR (48). I was not a runner, but was very active in trying to be fit and "well built" where I was young. What I have earned during my young days, is a healthy and strong heart. When in AF (last 15 years, paroxysmal), my HR goes much higher, even to 80-90 bpm, lol! If you have such heart as you do, with resting HR 52, it pumps well in both regimes - in NSR and in AF, so no fear that you may end with heart failure. I even do not take anticoagulants, what some people here consider to be Russian roulette, but taking anticoagulants from the age 55 till the age 95 (I do not intend to go away so soon, lol) would be almost the same. After long time with medication, many people end with kidney failure... All the best!
"Average" people have resting HR 70-80 bpm and, when in AF, it goes somewhere 180-220 bpm. Numerous people have reported such values. So, you are in the group in this forum, where people are "slow runners", with low resting HR, with sound heart and with relatively low HR when in arrhythmia.
Actually, the HR is essential -if the heart is beating slowly, despite in AF, it has relatively high efficiency and performs its task well. If, when in AF, HR goes as high as 180+, it means that the control system is trying to reach high enough blood flow-rate, but is failing. Such people feel dreadful when in AF and no wonder it is like that. Just calm down - you have done for your heart all that should have been done, so enjoy your strong heart.
Do not intend to be a nuisance, but here a few data that may be of interest to you. These are mostly the data I have collected in this forum, during the last 10 years. The lowest HR reported was 20 bpm, the highest reported was 250 bpm. There may be other, lower or higher values, but these are what I have seen and remembered. In the past few years, my resting HR has at first gone a little up, being from 48-52, but in the past year, when watching TV for longer period of time and being really relaxed, I measured 43-47 bpm. Will I end with a heart block!? No, I do not believe! With ageing, all of us undergo changes, but with my BMI of 25, being stable for the past 40 years, I do not expect any serious deterioration of the heart condition. What people in UK do not understand or do not want to accept, is that their worst enemy is the food and being overweight (officially, 67% are overweight or obese). This is the field where many could achieve improvement of the arrhythmia load, but easier said than done, lol.
As a former runner, I fully understand your concern about your heart rate. Advice is to relax and accept a higher rate preferably not above the 70's or 80's but below 100 is acceptable.
Don't panic, educate yourself about afib, monitor your condition, and make the best decisions. Check the below link if you have not seen.
Also ex runner, many miles per week. Which as BobD sagely commented is why a lot of use are here. Still do parkrun, slowly, but the rest of my body complains. RHR between 65-80. If you've got your head around the stroke risk, then that's the worst. AF imho is a stroke problem manifesting itself via the heart. All the NHS effort after the initial phase of ablations and cardioversions is to reduce the risk of stroke. You're amongst friends here.
When controlled for BP and H/R day (H/R Night avg 47) I was down to 88-93 H/R Day avg.
More energy. Then after a year H/R Day reduced itself to 60s. That was great and no increase in meds. Diltiazem 120mg AM and Bisoprolol 2.5mg PM.
I got to have my Johnson & J TVT Sling TVT removed but warned if my H/R was more than 100 they would not operate. At rest it was 93 in his office.
So you see H/R under 100 is normal rate. At rest of course.
Cardioversion is usually a tenporary procedure to see if normal rythmn can be obtained.
As my ECHO showed an enlarged behind chamber so I cannot have a cardioversion, ablation or given anti rythmn meds. So I need to rely on meds.
The CCB Calcium Channel Blocker saved me as I had an avg Day H/R 156 and over 120mg at rest. It controlled my H/R and reduced Bisoprolol to 2.5mg PM. Separating CCB from BB (like the NZ Heart Foundation said).
I was diagnosed with Stroke & Rapid and Persistent AF. 4 days later plus Thyroid Cancer. Removed 4 months later. I was lucky. No meds prior. That was in 2019/2020.
Being anxious makes AF worse. The Bisoprolol BB will stop the Adrenaline from entering your heart muscles. A CCB stop calcium from entering your heart muscles.
It takes time unfortunately to get the balance.of med to contrl your AF.
Some folks have PP pill in the pocket when you are in AF.
Try not to worry and see the Heart Specialist as you see him/her appointment.
Firstly, thank you all so much for your superb advice. I am afraid worry gets the better of me.
My Average HR is 90, so below the 100 limit, but they still upped my Bisoprolol to 7.5mg daily. I live near a major cardiac centre here in the UK and can always contact the cardiac nurses who basically say carry on doing the things I do and excercise as I feel fit.
I am listed for cardioversion. I thought about getting a monitor watch, but apart from telling me I am in AF which I already know it would probably freak me out regarding my heart rate!!. I am quite competent at taking my pulse, but again in AF there is the issue of pulse deficit, so difficult at times to reflect a true reading... I need to sit in there and wait for the cardioversion.
Thank you for the advice regarding Stroke. MY BP is fine, dont smoke and never had, watch my diet, although a little overweight and hardly drink which I think I may stop entirely. Also taking Edoxaban, so don't know what else I can do. CHAD score was 2 when diagnosed
Hi, my personal experience so may well be irrelevant. EFR is on low side, mine was, not caused by Afib but by badly leaking heart valve, also contributed to my pulse being around 50-55. So have you had a recent heart scan, my scans did not pick up the severity of the leak until I had a TOE. Might be worth checking out.
Also had v bad tachycardia, would make me feel as if Iwould faint, needed an ablation to fix.
Cheers. Yes my EF was reduced as I was in both in Afi b and tachycardia at the time ,so the technician commented on this, and the fact I was I Afib.....This will reduce output...Would be great to get in NSR, but I am not holding out much hope after this time....Just want the HR to reduce a bit!!!
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