is it normal to have a heart rate of 70 but be in AF
I am on beta blockers and flecainde so would the beta blockers be keeping the heart rate in check but the Flecainde not be keeping the electrics in my heart in rhythm as it was hoped
AF and heart rate : is it normal to... - Atrial Fibrillati...
AF and heart rate
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BobDVolunteer
The most important thing to know about AF is that there is no normal.
AF is defined by a lack of p wave on an ecg not by any specific rate. Many people have low rate AF just as for many it is always a high rate. Both groups have their challenges but I guess most people with low rate AF suffer less trauma , in fact many in this class are quite unaware that they have AF.
Thanks Bob
So with my normal high heart rate (without the blockers )could I have a high heart rate but no AF at times ?
The cardio doctor has always linked AF amd high heart rate for me but could there be no link ?
No idea what your normal rate is but "normal" is between 60 and 100 within which doctors seldom treat.
I was in hospital with 146 and 133 both 5 days stay which was down to AF so I guess I’m thinking do they go hand in hand
Not wishing to belittle your suffering but those rates are actualy quite low. Many people suffere rates well ovr 200 during events, some suffereing severe chest pain to boot.
The primarly purpose of beta blockers is to reduce heart rate whilst a patient is in AF and that of drugs like flecainide is to attempt to stop the arrhythmia in the first place. The two types of drug are usually prescribed together because flecainide can actually cause high rates by introducing flutter (which is a different arrhythmia.)
Yes Bob I have a friend with 210 who collapsed
180 is my danger level I was told 120 concern 140 A and E. it’s the gasping for air like a fish why my GP sent me to A and E the first time as it happened during my routine asthma check and had been for days off and on even talking in the phone made me breathless
It’s not the AF that ever concerns me it’s the breathing issues that scares me
Sorry to hear that but the two are not connected really other than that the AF exacerbates the asthma.
It’s a puzzle as I have had an echo /only mild MR / low normal EF / lung x Ray ok and the cardio doctor is insisting that the AF is the link . I asked direct about HF and he said not in his opinion is there any evidence
Asthma peak flow 550-620
I wish my peak flow was anywhere near that, mine is 270 max. But not very breathless so something strange is going on…..
Glad you mentioned that. My asthma peak flow is averaging at 270 also. My heart rate is on average 48, but them can to down to 42 - 45. Any episodes of AFIB and my heart rate goes up to 70. (I'm not on any beta blockers etc - only amiodarone and rivaroxaban. Recently while having some (non-heart tests) done my BP rose to 190/60. It is indeed a puzzle. At the moment I'm more concerned about my BP than anything else. I only have AFIB episodes once every couple of months. Any comments valued.
The echo didn't show any probability of pulmonary arterial hypertension?
no nothing was mentioned but it did cross my mind
Had an echo countless ecg around 12 , chest X-ray . A separate lung X-rays then a CT scan to check the arteries and nothing
I even asked the cardio doctor last week if there could be anything lurking and he was positive that it was fine
I personally don’t believe this is down to AF
The test showed mild MR low normal EF amd midly dilation of which he said is not a issue at this time
He explained the wrong percentage of blood is going into my heart chamber due to the electrical movement being wrong and flecainde needs to control that
My issue is I don’t see many AF suffers finding it a chore to do daily tasks through having to catch there breath constantly
I couldn’t think I’m going to walk 5 miles today like I use to to do any activities I have to see what the breathing is like
At time I sit next to a fan just to get air moving that seems to help
Please do not be led to believe that unless you have a heart rate above 180 there should be less concern. As I got older, my heart rate in afib became lower, but I actually became more symptomatic.
Any elevated heart rate in afib should be taken seriously and dealt with rate and/or anti-arrhythmic medications.
Jim
BobD: Not wishing to belittle your suffering but those rates are actualy quite low. Many people suffere rates well ovr 200 during events, some suffereing severe chest pain to boot.
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Except you are "belittling" the situation and sending the wrong message. You do not have to have a HR "over 200" to suffer. As I got older, my heart rate when in afib dropped from the 180's to closer to the 150's and 140's, however I suffered more at those rates.
And beyond suffering, an elevated heart rate while in afib can do damage to the heart over time and should be brought down ASAP with either rate and/or rythm drugs. That is the right message.
Jim
That’s interesting to know.? My afib rarely goes above 150, it’s mainly 120 to 130s. I’m guessing it’s the 10mg bisoprolol that’s keeping it down there.?
I must say Iv gained so much knowledge since joining this forum. 👍
my last AF attack was around 148, but no suggestion of hospitalisation, just Bisoprol tablet, but it did take 2 tablets but began to come back down after around 2 hours, i dont know your condition, but as someone said before no hospitalisations usually as 146 is something the B.Blockers should solve at home, my husband was taken in with over 200 bpm once, and had to have the electric shocks before it came back.
I was 142 went sent to hospital by my GP then in hospital they kept me in 5 days as it wouldnt drop under 133 then 100 on the 4th day I wasn’t even allowed to get up for 24 hours
BobD
Re your comment, “most people with low rate AF suffer less trauma , in fact many in this class are quite unaware that they have AF.”
This is actually incorrect and misleading.
AF can be just as symptomatic with low heart rates. I know this from personal experience.
hi
interested in your comment ‘low rate’
I have PA, Kardia says most days ‘signs of’ or unclassified; no real symptoms apart from HR a bit too high while cycling. Nothing drastic. Is anything known if Low rate leads to High rate or can it remain at that level indefinitely
thanks
That’s right.
My normal heart rate is around 60. I was unaware I was in AF, my smart watch picked it up when I started wearing it- at that time it was 80. So yes heart rates can be 'normal' in AF.
I have no idea what is normal and what is not normal. Last night my heart was bouncing around all over the place. It would go from 40 to 180. I have been in afib while my heart rate is in the 60's, 70's and 80's.
I'm no expert but I thought fast heart rate was a feature of AF as the heart has to pump faster to get the necessary effect. In AF your heart doesn't pump as effectively as its out of zink.
As Bob said earlier in the thread, fast rate is a feature in some AF cases and not in others. My persistent AF, before my Ablation, never featured an abnormal heart rate.
Interesting. Is Afib then an umbrella term with different types /degrees within it? The explanation I received from my cardiologist was that the fast heart rate was a compensatory effect due to poor pumping from the consequences of Afib. Unless of course the rate at which your heart pumps can also be affected by faulty misfiring within the heart affecting rate control?
I do find it complex.
There is certainly a wide range of variables, which is why one size does not fit all when it comes to treatment. I'm sure your EP was right that the rate increases to compensate for poor flow, and I guess we can therefore assume that the flow is not so badly retarded in those with no increase. I know my Ejection Fraction was still 47% in AF, which was considered satisfactory and may account for the very small HR increase in my case. Mine went from around 60bpm to around 70, so still a long way from tachycardia.
I agree with you. My heart rate even on meds is still in high 90s. Since am now post mini maze op early days recovery it has dropped a bit. . However my heart probs are due. to cardiotoxicity so was told not technically straightforward Afib.The heart is a complex beast....with many factors at play! 😊
That’s pretty much what he said you put it very well
He said my heart is pumping to fast most of the time and the electricity ( I think he said ) was confused by it so to much blood is in the chamber
My EP said its rogue impulses causing the heart to fire at the wrong time and too frequently which affects its ability to pump efficiently....ie fully empty. The heart drugs are designed to slow down the rate and therefore control flow. In reality there's all sorts of forms and degrees hence the wide variety of responses. Your best bet is to ask your EP to explain it to you again. Mine is very nice & gets my limited medical knowledge...but need to ubderstand. Plus maybe it's easier to understand if your electrician!! 🤣😂
Trouble is here it’s every 6 months to you can see the specialist but I understand your point
Thanks
Mine are annual but maybe you can contact the EPs secreatary who can email the EP?
Only way I get a reaction from the secretary is to go via PALS never return a call never answer a call
Sorry to hear that. How frustrating!!
Very to be honest
I have never heard that. I was told the rate was down to the number of impulses the AV node allowed through, scary quote to me ‘Your atria are beating at 300+ per minute but luckily the beats can’t all get through, otherwise you’d be dead’. Your explanation would imply that stronger hearts beat faster (driven by the ventricles?) to make up for the irregularity. During a recent run of persistent AF I found my heart speeded up when my BP went down, apparently in an effort to get enough circulation going.
I'm not sure I follow.... I certainly didn't imply anything Butterfly. I didn't say how strong the impulses were either or that the heart was driven by stronger beats.... That's what you have made it mean. Just that the EP said they were rogue impulses (his words) causing the heart to beat out of rhythm thereby the heart doesn't have time to fully empty or fill. I was told I was likely to have impulses getting through from more unusual areas that catheter ablation can't reach. He also told me the my Atrial Fibulation is different because it's caused by cardiotoxicity so not the usual Afib (I've no idea what he meant by that!!) ..... Lol. Such is life and why it left me with the mini maze option as the only way forward as medication was failing.
No, I said that my understanding was that the speed was based on the number of impulses from the atria affecting the ventricles. That’s all. I am trying to understand how the speed is affected in any other way.
Sorry I don't understand Butterfly. Happily give you my EPs name. This is way above my skill set. Sorry.
Are you scheduled to have a mini maze? And where?
Hello Weren, I'm just recovering from a mini maze op, carried out by Mr Hunter, Northern General Hospital, Sheffield, UK.
How are things since your mini maze?
Aww thanks for asking. I've been in NSR ever since..... 😊However the less than friendly Amiodarone I was put on for one month has caused havoc with my thyroid so recovering from that. But NO Afib. Long may that continue....
That’s what I was thinking before but now I’m not totally sure
I have been in AF and on both drugs and HR can hover between 70-80 having said that when I’m not in AF I am usually in the 55-60 rate so that’s how I know.
My Kardia has recorded AF when i have had a pulse of 48 due to beta blocker
I get breathless when my HR is high. And beta blockers can cause breathlessness. Even a low dose caused this for me. Enough to come off them. They are not normally prescribed for people with asthma. Lowered EF could impact breathing too. But I think higher HR and the meds would impact more significantly if mild. That was my experience anyway. I still have reduced EF but lowered HR and no beta blockers means breathing much improved.
What beta blocker r u on? I get very breathless too
I am on Bisoprolol 10mg a day
I know it high that concerns me but if I drop to 5mg my beats hit 140
Same as my husband
I'm not now but was on bisoprolol. Lots of people struggle tolerate it. I was very breathless on it.
Yeah I was bad on that
My trouble is I was breathless without it gasping like a fish with a HB 130/140 now with it I still get breathless at times just walking up stairs or doing basic DIY but before I could be sat down and find myself gasping like a fish out of water
When I drop my beta blocker mg I am struggling to get air in my body it’s like I can’t get enough in for what I need
My original AF (persistent) was in the 100s, but I went into AF(now persistent again) for a 2nd time a week ago, some years later, and this time my pulse is 80 plus or minus. I'm assuming it's because the bisoprolol I take stopped it from going crazily fast this time.
That’s it!
A "normal" person without AF has a heart rate of between 60 and 100. My episodes of AF were of a much higher rate, until I was prescribed Flecainide which stopped most episodes. I would have 1 or 2 short episodes a year.I now have permanent, though asymptomatic AF, usually with a heart rate around 85bpm.
I’ve had AF at roughly that rate on occasions, although usually it’s higher. I found that if I ate anything it would increase the rate. The cardiologist advised going to A and E if the rate was over 90 for more than 20 mins, so if your AF stays slow you might be able to sit it out. But, obviously check this with your GP as I am not medically qualified.
I think most A & E's would not worry over rates of 90, in fact when i was taken in a few months ago with my first AF episode, they let me go home once they got the rate down to 90, as 60 - 100 is the normal rate for everyone, mine has always been around 53 all my life.
A&Es often take a different view to cardiologists. They are aware that the 90 or above criterion would likely increase the number of patients they have to treat at a time when they are under pressure. All the cardiologists that I have asked, however, advise that 90 or above is the right criterion.
I wouldn’t imagine they would
Yes we were told the same at the consultants
I haven’t taken flecainide but I have had AF with a normal rate; in fact, an elderly friend permanently has AF with a normal heart rate and no other treatment (except warfarin).
From what I’ve read, the ventricles don’t always react to the fibrillating atrial activity by beating faster, but often do. I doubt the bisoprolol is slowing the heart by very much.
Steve
What would the Bisoprolol be doing then ?
As I understand it, the effect of bisoprolol is to reduce the heart rate and blood pressure but only relatively mildly (in the sense that it won’t slow the heart from 150bpm to 70bpm).
When I have AF, bisoprolol sometimes stops that, too, presumably by calming the heart down overall. For some people here bisoprolol doesn’t help the arrhythmia at all, so it must depend on the root cause of it.
Steve
Sorry but dissagree, when mines goes to 148 as did a few weeks ago, admittedly it took 2 bisoprol 1.25 mg tablets but in 2 hours it went back to my low normal h.r. of 53 ish. Bisoprolol do bring heart rates down in AF, and this is what 111 told me to do do at the time, i have the paroxysmal AF i.e. infrequent, have given all alcohol up as even one drink can and will bring on AF in a lot of people.
Yes, I agree - and that is the dose that I take (1.25mg a day, but an extra tablet as needed, up to 5mg). Isn’t the big reduction only when it stops the AF? I might be wrong but I didn’t think it reduced the heart rate so dramatically unless it stopped the AF.
If you look up Bisoprolol on the NHS - I just did - it says it lowers BP, slows the heart rate and takes about two hours to take effect. But I expect the effect depends on the person.
Yes, thanks - I was trying to say that bisoprolol has only a modest effect in lowering the heart rate, for example, in studies it seems to reduce the rate by about 12 bpm.
The big reductions in rate some are reporting in this thread suggest that the bisoprolol is doing more than reducing heart rate: it is also stopping AF (which often leads to tachycardia of, what, 150+ bpm). Thus the heart rate reduction will be significantly greater, not because of the bisoprolol's heart-rate reducing effect per se, but because it has stopped the cause of the tachycardia, the AF.
Steve
Yes it doesn’t help my husbands A F but keeps eighties and nineties instead of 160+ when he had his stroke
When I used rate drugs like bisoprolol and diltiazem during afib episodes, I could slow my heart rate down from the 180's to under 100, which made me safe, comfortable and able to function with daily tasks until I converted.
Bisoprolol is a weak anti-arrythmic, so in cases where afib resolves after taking bisoprolol, it could just be coincidental, but in any event, you really do not want to stay at high rates any longer than necessary.
Jim
Indeed. I’ve often wondered whether it’s not so much its very weak anti-arrhythmic properties as its overall impact on heart function (increasing oxygenation of the myocardium and mildly decreasing blood pressure, for example). Those effects seem, for many people (judging from the amount prescribed), to help stop AF. In my case (fingers remain crossed), my AF has been kept at bay since March when I was started on 1.25mg daily instead of taking as needed.
Steve
i don’t want to upset anyone but I wonder does all this checking pulses and heart rates make matters worse for some people as worrying about heart rate maybe causing it to start up I’m pretty lucky these days I done have a afib attack very often plus it’s not painful as it use to be but I do take magnesium taurate each day and the cardiologist wrote to my dr saying he thought the magnesium was helping so I often forget I have afib I also take verapamil and apixaben I hope no one thinks I’m saying people are fussing but so many of us with afib seem to spend a lot of time checking there watches and taking there pulse god bless to you all
Pearce I think that's a fair comment. I'm having to check my heart rate three times daily & record as part of my recovery from my op. It does make you more aware..... though it's not anxiety causing current heart rate. I think a lot of it is people not being sure what is and isn't OK for them. The hearts a complex beast so there seems to be a lot of variables which is confusing. And in addition peoples level of tolerance and response to different medications vary.
Hi
I guess there comes a point when one doesn't worry about the checking.
Which is me and I got a fright that last November that Diltiazem 120mg had again lowered my h/R Day. Controlled in December 21 at 88-96 to 60s. What a good surprise.
I had last 3 kg and I now drink A2 milk.
Now lost 5kg.
70 H/R at rest is very good.
Although H/R dropped I still have persistent AF.
As long as under H/R 100 you can have an operation.
cheers Joy. 74. (NZ)
Agree, I have stopped doing this and I do think it keeps my heart rate down as I don't panic so much
Hi
Yes H/R any level - it just means an irregular heart beat.
Talk to your H/Specialist as Flecainide is not keeping the rythmn.
As I have an enlarged back chamber, I cannot have a cardioversion, ablation or flecainide(an anti-rhythmic drug-quite risky).
Sometimes flecainide causes flutters, abnormal rythmns etc. You must tell your Dr/H-Specialist.
cheri JOY. 74. (NZ)
Afib can be at any heart rate. Don't know you full history, but Flecainide is given to either get you out of afib or to help prevent episodes. Not saying this is what you 're doing, but Flecainide is not a drug that you just take while in afib if it isn't getting you out of it or preventing it.
Jim
So why is it used as a pull in the pocket
I used to get really rapid heart rate when I had an episode (I am paroxysmal), but now my episodes seem to stay with a heart rate around 70 -80 but I am still in afib and my heart rate is very irregular. I take Sotalol which is a combined beta blocker and antiarrhythmic, unfortunately it doesn't stop the electrical disfunction
I don't know about "normal", but I have *very* noticeable symptomatic AF that is horrible and exhausting, but my heart rate overall is not high during episodes.My underlying rate remains anywhere between 60-90bpm, with irregular and erratic beats sometimes close together, and sometimes far apart.
Like Karendeena, I take Sotolol, which doesn't stop my arrhythmia any more, really.
Rate control and rhythm control aren't the same thing, it seems. 😏 I never struggled much with the rate part - only the rhythm part.
Maybe you are the same?
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