I was mostly Afib free since my ablation in March, 2O22 until August of this year when I had a 4- hour Afib episode. Since then, it has been an almost daily series of a few Afib episodes but showing either “Sinus with supraventricular ectopics” or “Sinus with Wide QRS. My heart rate is always around 50-52 during these and often in the 40’s for which which neither my Kardia nor Apple will give a reading.
In my research, all I can find about wide QRS is “QRS with Tachcardia” which can be dangerous and may need conversion. I have an appointment with an EP on Oct. 19 to discuss this and the possibility of a second Ablation. My Cardiologist told me to be sure to record my heart rate during the wide QRS episodes to show the EP. Anyone here have this experience? Would appreciate any feedback. Thank you.
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willec49
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My only experience with "Wide QRS" was when I captured it on my Kardia right after exercise. It was just after my Flecainide dose was increased. I showed the ekg to my ep and he reduced my Flecainide dose.
That happening to you during exercise makes sense because they watch for wide QRS during maximum heart rate in the treadmill test which may indicate a problem. And my Cardiologist did double my Flecainide from 50mg. to 100 mg twice daily when the Afib returned. Thank you.
FWIW after I went back to 50/50 not only did my symptons go away, but it turned out to be the right dose to keep me in sinus rhythm. We probably jumped the gun going to 100/100 without giving the 50/50 more time. Some time less is better with Flec.
Hi Jim. I know what you are saying. I was on the 50/50 dose since the Ablation. I need to remember that getting the Flu shot and then the RSV vaccine a week later precipitated the return of those episodes. But I never expected that reaction after getting the Flu shot and 5 COVID shots with no reaction at all. I think I will try cutting back to the 50/50. Thank you; You really made me think.
After trying various does under the guidance of my ep, 50/50 ended up being my sweet spot although I actually did OK on 25/25 for several months. What I liked about 25/25 was that I was allowed to go off my nodal blocker (diltiazem), however after a while it did not hold as well as 50/50. I didn't go into afib from the jabs, but did go into afib from Covid. At the time I was on 25/25. Thinking back, I should have preemptively upped the dose to 50/50 as soon as I noticed my Covid symptons. This brings up another strategy to go over with your ep, being to premptively increase Flec dose during times of stress, illness, etc.
Hope you find the right FLec dose/strategy for you.
My Kardia regularly told me I had a "NSR with wide QRS" and, I gather, this can occasionally mean there is some kind of conduction abnormality and delay in the ventricular contraction occurring. In my case, I've been told that this is being caused by a "left bundle branch block".
If yours continues to flag this finding up, I think it would be worth asking your GP to investigate further.
I have had LBBB long before AF. This affects the EKG and makes it less informative. I have been told I cannot have a cardio version because of it. When the LVEF is less than 35%, one suggested solution is a pacemaker for resynchronization and a heart defibrillator. These options are not without their negatives so be sure your doctor definitely knows what to do and when to do it.
A heart MRI may be beneficial to analyze the condition of your heart. Without it, the decisions are probably less informative.
I did not receive a treatment. I had the LBBB long before I got AF, now permanent AF. The heart re-circuits itself with a bit of a delay. I too had a low heart rate. I was told by one doctor that I could not have a cardio version because of the LBBB but another doctor said I could. One was never recommended by EP doctors is all I know. The LBBB affects the EKG chart making it less useful. I was told the only solution was a pacemaker and a defibrillator should my LVEF be less than 35%. There is a bit of guess work (judgment) to arrive at this percent. I had an MRI, an echo and a nuclear medicine test and each gave a different result. Mine was over the 35% so I can pass for now on these solutions. The actual number can have a variance of maybe 10% or so depending on the device used and the ability of the technician reading the test result. Solutions offered can also be based on your present quality of life. Mine is fine on the drugs I am on so another reason not to mess with this. Perhaps the risk is a medical intervention could lengthen the QRS interval. Some drugs do for sure. Too long at any point in time becomes flat and flat is not good. Something you should query your doctor about.
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