Without getting into a lot of detail, I will try and get straight to the point. I’ve been told I can make a novel out of one tiny incident…..lol
After having a Holter monitor for 72 hours, my cardiologist wanted to see me right away. He said he was concerned with the slow and fast heartbeats and has referred me to the arrhythmia clinic at the hospital. My anxiety went up and I know I didn’t ask the questions I wanted to. I wish my hubby were with me. He is the calm one. I will say that during the 72 hour monitor I had an Afib attack that lasted 12 hours and stopped sometime during the night when I was asleep.
My Afib events are every 15 to 21 days. They are that regular and have been for 7 years. Weird isn’t it? I have learnt to live with it and overall my quality of life isn’t so bad. I still do everything and can function pretty well during an attack. I just painted my entire house inside….lol. I walk an hour every morning and have a healthy diet.
My Blood pressure is excellent and cholesterol is ok. I only take metoprolol as a PIP to bring heart rate down from the fast AFIB and anytime I find my heart beating a bit too fast and of course the trusty Eliquis that I wouldn’t do without. So I think overall I’m doing pretty good.
What has me concerned is when I got home I looked at the referral information and it stated a “conversion pause of 5.58 seconds” and a recommendation of a pacemaker vs an ablation. I was in complete shock because not one time did the cardiologist mention any of this. Maybe he didn’t want to say anything because he saw my anxiety.
It is my understanding that a conversion pause is when one goes from Afib to NSR. Am I wrong?
I would really appreciate any advice from you wonderful people. All of you have a wealth of knowledge and it is fantastic that you are willing to share your experiences so that everyone can benefit and not be so afraid of this mongrel condition….. AFIB.
Thanking everyone. It might be hard to respond right away considering the 5 hour time difference.
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Quick one because I have to do some work! Yes, had the same, found it on my trusty Kardia, same recommendation, had ablation, all seems okish though AF came back. Got slight tachybrady syndrome, still odd mutters about pacemaker but doesn’t seem urgent ❤️🩹
Short pauses between arrhhythmias and NSR are not uncommon and can cause presyncope (feeling dizzy or even fainting) in extremis. It could well be if you are having asymptomatic events whilst sleeping that this was picked up during that period.
A pacemaker was suggested to me following a similar monitor session but it took my excellent EP two years to actually pursuade me I needed it and then only after a couple of "what the heck was that " moments. Apart from the normal installation recovery process I am quite unaware of my PM but happy it is sitting there as a safety net.
Thanks so much BobD for replying. I think from what you've said my future is going to be a PM. I have had some "what the heck was that" moments as well. Feeling that one's heart is skipping a beat or actually stopping. It's a scary feeling. Thanks again. I will update my experience with arrhythmia clinic.
I had a couple of moments working in my workshop when I had to suddenly drop to my knees for fear I was about to black out. On one occasion I did manage to call out to my son who was on the other side of the shop but by the time he got to me I was clawing my way back up the side of the bench looking sheepish. lol Never actually lost consiouness.
Second degree heart block I was told. No, in the end I took pity on my EP of 17 years who told me he would sleep better at night if I accepted his advice. I have had worse things happen to me. lol 😁 My reason for reluctance was the instant ban on welding (Mig, Tig etc) ,induction hobs less of a problem to me with an AGA but since my second son is now a better welder than I ever was I don't need that worry.
mmmmm. Heart block. More stuff to google.....lol. I can see your reluctance to not proceed considering your love for welding and car engines and such. And you are very fortunate that you have a son who likes welding. Best wishes Bob. I will keep you on updates. Have a super day.
hi, I used to find conversion pauses unpleasant but could always tell when my AF had finished! My heart rate would then drop down into low 30s and that was worse than AF, I have recently had a pacemaker fitted and heart rate does not go below 60bpm and so far I have not had an AF episode for 3 months since the fitting which has surprised and delighted me.
Hi JudiHalf. Glad to hear from you. Yes, that is exactly what I experience. Low heart rate after AF stopped. Nothing as low as 30s at least as far as I know. I haven't had any fainting spells, thank goodness but I sometimes just don't feel myself. Find I have to take deep breaths at times and then I feel better. I can still take my walks with my loyal dog every morning. My concern is the pauses and wondering if my heart will just stop. Lots of questions for the arrhythmia clinic, eg: how many do I have and when. Questions I should have asked cardiologist but too much anxiety. I didn't get one bit of sleep last night. So glad to hear that your AF episodes have stopped since having the PM and I wish you continued success being AF free. Thanks again.
We're far from experts here, especially with pacemaker criteria, however from what I've gleaned, 5.58 seconds is far from a "short pause" previously mentioned, and must seriously be followed up as soon as reasonable possible. With something like a pacemaker, a second decision is always reasonable, depending on how they lay out the situation.
Hi Jim. Yes that is exactly right. 5.58 seconds is NOT a short pause. I hope to get to an appt to the clinic soon. My anxiety is going through the roof. Thank you
Before my mini-maze I fainted twice. The feeling is of an "electrical rush" through the body followed by feeling faint. These events made me decide to bite the bullet and have a surgical ablation. I am now in NSR and have had none since.
Ok so what were you referring to when you said surgical ablation? Did you mean mini-maze or have you also had an ablation? This is where the confusion came in 🤣
Also I’m assuming you had to have the mini-maze done privately in Japan? Can I ask how much it cost and how long it took you to recover?
A mini-maze IS a surgical ablation because punctures are formed on each side of the chest to pass the instruments to the outside of the heart to ablate the nerves. A catheter ablation tries to achieve the same result by passing the instruments via the vein in the groin to the left atrium and burns/freezes the inside of the heart.
The cost of the operation was 15,000 EUR. I was a lone paroxysmal AFib sufferers for five years, and had a fairly easy time of it. A week after surgery I was released from the hospital and walked 2 Km and felt well. Three weeks after surgery I walked >10 Km in 2:15 hours.
Ok that makes sense now 🤣 thanks for the explanation.
That isn’t as crazy a price as I would have assumed to be honest and that’s inclusive of everything. Travel, accommodation etc?
How is your health now in general? Do you have any issues with your heart at all? Such as sensitivity, or heart rate fluctuations etc? I had an ablation 2 years ago and it seems to have caused me more harm than good. It has its positives for sure but there are plenty of negatives too.
The total for me (hotel, travel, food, entertainment) was 18,000 EUR. It will depend on flight costs, and hotel seasonality. Restaurants are very well priced for Japanese style foods. A tray of Sushi (10 items) to take out was 4-5 EUR. Supermarkets and taxis are more expensive.
I am taking zero medications and at 77 have no issues with the heart. A few days ago I rowed for 40 mins, ran 1 mile the next day and swam 0.5 km and the heart stayed calm and low rate. I had some breathlessness with increased effort and it took 6 months to settle.
Resting HR is about 68 and HRV 24 (ms) rMSSD. When I exercise at 550 Kcal/hr my HR stays below 110 and averages 105.
Hi Cheri. I feel good now. I had five years with AFib when I was gradually doing less and less and my life slowed down by the fear of the next episode, so maybe this is my chance to get the most of the current opportunity.
I missed the top bit: you can't have anti-arrhythmic drugs, but Diltiazem is a calcium channel blocker anti-arrhythmic?
Would you like to chat with Lynn from NZ who went to Japan 3 months before me? She was persistent AFib with heart failure and is now in NSR and normal ejection fraction. It may be worth having a virtual meeting with Dr Ohtsuka (he doesn't charge) to go over you options.
All the best, and thank you for your good wishes. Yesterday was my 11 month anniversary. Saul
My heart is NOT structurally normal. It is enlarged at the left ventricle the ECHO shows. Could be that after the stroke they left me - no folloswup after stroke and then H/Specialist public still left me uncontrolled on 156 H/R Day. But always H/R Night 47 average.
You can contact her on the WMM FB group. It is free to join and the folks on it have had every kind of heart issue.
The enlarged heart may be an issue, but most of us have an enlarged atrium due to the AFib. Dr O can discuss everything (at a virtual meeting) with you.
Yes I had that snd a decision was made for a pacemaker. Touch wood no fainting or light headed since, but now although I’m not aware of it like before apparently I do have odd bouts of afib
Whether I will have to have a left side ablation at some time in the future I don’t know as EP hoping not as carrying on with low dose flecainide snd bisoprolol as well as apixaban.
Good luck and try not to worry too much. Easier said than done I know
I had long pauses wearing monitor and cardiologist thought I might need pacemaker. However the doctor who later did the ablation disagreed and felt the ablation would take care of it. Had the ablation last December and no more Afib and no pauses.
I used to get presyncope when converting back to nsr. It was only when it happened once when I was driving that I realised how dangerous it might be. I have had a pacemaker for nearly 10 years now (aged 73 at the moment) and waiting for my appointment to have a new one installed, wish they could just plug me in for a recharge 🔌😂. Only drawbacks are airport security scanners and induction hobs. Do check with your drivers license regulations in Canada too.
Diltiazem is not a anti-arrhymic med - IT IS A RATE H/R reducer. Within 2 hours on 1/2 dose, my Day H/R dropped 105bpm!
The 180 mg was reduced to 120mg. I take it 1hr thyroxin my thyroid daily med.
The bisoprolol was reduced to 2.5mg and separated to PM.
I had a stroke in Sept 2019 caused by AF with undiagnosed Thyroid Papillary Cancer.
Before stroke no meds. Put on Metoprolol which I said no to. Given anyway and reduced it. 24-heart monitor showed pauses at night. Not there with Bisoprolol or Diltiazem.
Bisoprolol controls my BP.
Diltiaprolol controls my H/R for 12 hours only. My usual H/R stays at 47 avge regardless of meds. Always cold shoulders at night.
Flec..... is a very risky drug.
Bringing down BP and H/R in itself reduces the rhymn frequency. The private Heart Specialist noted in his report BEFORE he knew of the reduction of Day H/R wrote,,,,, Joy can up to 360mg Diltiazem! That may have stopped my heart altogether!
At a weekend so rang Healthline on Sunday and spoke to a Dr there. Then Wednesday to NZ Heart Foundation where the nurse there and knew Dr Brandon Wong! I think she phoned him as a quick change in my dosage was dne immediately.
Diltiazem is a powerful med.
I am happy now on 110-130. BP. with 60s H/R DAY REST. (was 88-96 until last November)
With the thyroid cancer removed - Thyroid and 12 lymph nodes on right side. (2 were infected). I declined RAI and Suppression. Low Risk for return or left.
3 x yearly neck scans show ALL CLEAR.
There is a chance that my heart irregularity may convert itself to normal.
I'm saving up for $5,350 on 2 crowns and a bridge in gold so that I can eat!
cheri JOY
Your success story will be taken up by some folks.
I go by the literature, I am not a doctor and am trying to help. I have no personal experience of Diltiazem . Please check with your cardiologist.
"Diltiazem is a calcium channel blocker medication used to treat high blood pressure, angina, and certain heart arrhythmias. It is sold under the brand name Cardizem1. Diltiazem is a Class IV antiarrhythmic and one of the most common pharmacological agents used for treatment of AF with RVR2.
Diltiazem is also used to stabilize heart rhythm and reduce symptoms of atrial fibrillation over time. But, for those living with heart arrhythmias like atrial fibrillation, the heart rate is no longer regular or controlled — a situation that can be improved by adjusting the amount of calcium entering and leaving the cardiac muscle."
Definitely stopped the presyncope but not the Afib, I have had 2 ablations since the PM was inserted with 2.5 years of complete peace and although it's back again it's a lot better than it was. In UK you have to declare the heart problem and presyncope on Drivers license so check your requirements for Canada.
Hi, I used to get these when using extra Flecainide as PiP. I'd get presyncope- rapid breathing, a.massive hot flush and room spinning round. Not at all pleasant.Once we caught it on my Kardiamobile- a momentary flatline!
Currently I'm not getting AF post 2nd ablation so hopefully won't have to go through this any time soon.
I can see you're getting lots of useful input re pacemaker.
With me I had afib/tachycardia which was so uncomfortable that it felt as if the settee or bed wherever I was sitting was thumping and acrobats not just my chest and back
I was put on a regime of apixaban, bisoprolol and flecainide which worked beautifully. Then a few months ago my heart rate kept dropping to below 40. Got to fainting lightheaded stage and taken into hospital. Was told by consultant that the pills were causing the low heart rate. Stopped all pills while in hospital and all returned to normal, but then afib/tachy reared its head again
Consultant said like yours PM -v- left sided ablation. At first the team decided on ablation But there was no guarantee that ablation would stop the afib/tachy and so it would be back to pills and then low heart rate again. So decision for pacemaker was made. Although I have only had this since beginning of September I feel so much better. Touch wood no faints or light headed
Yes the monitor could see I had some afib 2 weeks after the PM but I guess my heart had to settle down. The good thing I never felt a thing
Whether eventually I ever do have to have the ablation in Harefield eventually the consultant hopes not?!?!?!
As you know the PM just makes sure heart rate doesn’t go below what it is set at. In my case 60 which I think is the norm but won’t stop it going high. However after they did mine I heard there is a pacemaker that does both high and low. Unfortunately I didn’t know that at the time otherwise I might have asked for that one if NHS did it
Please excuse this long post, but I just wanted you to know why pm -v- ablation
In my experience and my husband's no worries about the PM. Just for the first 4-6 weeks you are not supposed to raise your arm any more than out straight although literally minutes after the procedure they take you for an X-ray and the radiographer said to me put your arm on your head, meaning the right arm, but I automatically lifted both arms. Wrong!!! All was OK though. Also for the first 6 weeks try not to lie on your left side, but my husband has done and he is fine. Coincidentally we both were taken into hospital within weeks of each other for PMs. Same symptoms. He says it's because we like to do everything together! No stretching up high and straining to lift things down for 4-6 weeks and at nearly 80 I've given up painting the ceilings!!!!!!!
Just a case of being careful really, but like after any procedure just take care and will be no problems. You wouldn't even know it was there except for the little raised bump. The scar on both of us is unnoticeable and about 1 1/2-2 inches long
Most of our grandchildren are old now, but we still have a little 5 year old grandaughter who likes to play games, cuddle on laps, etc and also when she comes so does their dog who is beautiful, but scatty and no problems there even though she jumps up on our laps. Obviously you have to keep away from the wound until stitches are out.
If all well you can go back to driving after a week, but I didn't for about 3 weeks. You do have to notify DVLA that you have a pacemaker, but I received a letter back very quickly saying fine to drive. I did read somewhere that you have to notify your insurance as well, but in the Gov.co website it says that DVLA notifies them if any problems. Oh and also to keep away from induction hobs. When you leave hospital they give you a list of do's and dont's anyway.
Try not to worry and enjoy feeling great and no fainting/lightheaded
I was thinking that metoprolol might be an issue. I only take it when I have an Afib event. When I had the heart monitor on for the 3 days I did have an Afib event and took metoprolol. I need to find out from the EP if this 5 sec pause happened then or are the pauses happening at other times. Thanks
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Heart 'pauses' when inhaling..
Felt like my heart paused 
