Newly diagnosed PAF by GP

[Tropicaltaurus]

Hi everyone, i was diagnosed with PAF by GP after 24hr holter monitor and referred to cardiology in July. Still waiting for cardio appt but have had s 72hr monitor in the meantime. No idea about results of that yet. My question is how do you all tell what is an Afib episode and what is eptopics or other arrhythmias etc. I get all sorts of different weird feelings in chest sometimes. All i have been told about AF is what I've read on here snd google etc. Already on Bisoprol 1.25mg plus Ramipril for previous high blood pressure and GP put me on edoxaban as chadvasc score was 2. 😊

[Finvola]

Welcome Tropicaltaurus.

I had exactly the same question at diagnosis - what is it? Usually AF is fast and beats are totally chaotic but some people have slow AF, so chaos is the best indicator.

A rapid, regular heartbeat could be AFlutter or straightforward tachycardia. Ectopics are out of place beats in otherwise normal rhythm and can be felt as follows:

beat ...... beat ... beat .....................THUMP ....... beat etc

The best way to differentiate is with a Kardia recorder or similar or by taking your pulse and learning which is which. I find my carotid pulse easy to feel (either side of neck below jawline).

Edit: forgot to say that ectopics can occur randomly or every two, three or more beats.

[Tropicaltaurus in reply to Finvola]

Thank you very much for reply, this is the summery of my ECG and it shows lots of different rhythms but as i was asleep at the time of the AF (i think) i don't know what it felt like. Only symptoms i really had was my blood pressure tanked, i felt lethargic and my home bloodpressure monitor showed irregularheartbeat. I don't think I'm getting fast AF?

ECG summary

[CDreamer in reply to Tropicaltaurus]

What I would deduce from your post above and your heart monitor report is that your heart rate dropped, lowest recorded was 35 and that you had 111 Bradycardia events (slow HR). Heart rate always drops when we are asleep but going too low will cause the body to go on high alert as more than likely your O2 stats also drop. This can be a trigger for AF. The good thing is that no long pauses were detected. This gives the cardiologist some good information about best treatments, however, what I have learned is that YOU NEED TO KNOW THE RIGHT QUESTIONS TO ASK! And you need to do your own detective work. Too many patients, too few doctors and not enough time given to consultations means you need to maximise the time you do have with a doctor.

Suggestions:-

if HR is low and never rises too high then would it be an idea to review medication? Bisoprolol and Rapmpril lower HR as well as BP.

Given the information above, one then has to ask why is HR dropping so low and when and if at night, how often? I used to have most of my AF events at night and my sleep was not great and I never woke up feeling refreshed. If this resonates with you then I would ask for a screening for Sleep Apnea which can be a major cause of nocturnal AF.

Did you also have an O2 monitor during sleep? Worth investing in a small finger O2 monitor and keep a check. If you have a smart watch, they will often have these monitors and ECG/HR tracking capability already built in. I have iWatch and it is excellent for tracking and produces useful information for doctors, if you can print of report. Kardia is also an excellent suggestion and you will learn a lot - if it interests you - but some people find it can be addictive and become anxious wanting to know what every thump and bump is and anxiety will ALWAYS exacerbate the sensations and worsen the frequency of ectopics.

As others have said the only sure way of distinguishing rhythms really is ECG and kardia and smart watches both have the capability.

Hope that helps.

[Tropicaltaurus in reply to CDreamer]

Great information thank you, i have screenshot your reply so i don't forget when i eventually speak to cardiologist. I do have my own finger 02 device but obviously I'd have to be awake to read it. There was no 02 recording with the holter recorders. I did query that low heart rate with the GP but he wasn't concerned, but then again he brushed everything off and said wait to speak to cardiologist even though he also said i would likely be waiting months! Incidentally it was a different (and a trainee GP that put me on edoxaban after) I think i will ask GP at next appt about sleep apnea screening. Thank you very much

[wilsond in reply to Tropicaltaurus]

Nothing to add to CDs post except to say,if you can run to it,you can get a private Cardiologist or even better an Electrophysiologist, very quickly for an initial consultation. Usually within days or weeks. They they transfer you back to the NHS . About 200.000. Take any results/ prescription/ notes with you.Then you will know the likely plan of action.

I had slow AF and bradycardia too.

Best wishes.

[Tropicaltaurus in reply to wilsond]

Thanks for reply, money is tight as hubby been on sick leave for months but certainly something to consider!Interesting you had slow AF too, how have you been with it if you don't mind me asking?

[wilsond in reply to Tropicaltaurus]

Since my ablation at UHCW June 2022 have only had a few episodes,and my HR is now around 55 average.I had flutter as well,which goes very fast but regular.

Slow AF floored me most times. I had to take a beta blocker to try to stave off flutter but could only take 1.5 bisoprolol .( at night was better for me)

I felt lightheaded,dizzy,fainted and few times and generally dreaded AF!

I was put on flecanide as a pill in pocket which worked fine for a while,then as a daily dose. Several years later, AF began to get the upper hand so ablation was decided. Covid postponed it but eventually got it done.

Remain on AC and hope to get off flecanide in April.

Best wishes to you n hubby

[Buzby62]

Most of us here can relate to your lack of knowledge when diagnosed which is normal. It really is down to the individual to read up on the subject in my opinion, you need to learn what type of AF you have and how to manage it. AF is so different for everyone and that is the first thing to learn, it’s great to get opinions and reassurance from others on here but I would suggest reading the Resources on the AFA website starting with the AF Patient Information Booklet.

Patient Information link api.heartrhythmalliance.org...

Link to all the AF Resources heartrhythmalliance.org/afa...

Hope these help

[Tropicaltaurus in reply to Buzby62]

Thank you, i have read loads and i will read these links but so far nothing has really answered my question. I guess it can't really as like you say everyone is different. I just wanted to get people's experiences of what there's actually feels like. I think having been diagnosed (the doctor told me nothing except the stroke risk) and still waiting to actually speak to a specialist (which will only be a phone consultation) has left me unsure of so many things such as what has caused it etc. I know no one on here can answer that but as someone who likes to understand things healthwisevi am struggling

[Buzby62 in reply to Tropicaltaurus]

I was diagnosed late 2020 during the pandemic so getting a referral was nearly impossible, like you I wanted to know all the answers and paid to see a cardiologist privately. I actually went in to AF while sitting in the waiting room and I didn’t know until he took my pulse manually and said AF. He didn’t do much more than what your GP has done. Gave me apixaban and the smallest dose of bisoprolol and ordered an echocardiogram privately to check heart structure which was all normal. Reverted then to NHS for six monthly reviews which were actually much longer. Knowing what I know now I would have asked to see an Electrophysiologist sooner and maybe done that privately in the first place. Your GP appears to have done right by you and given you the protection medication.

[BobD Volunteer]

Learn to take your own pulse. If AF it is irregularly irregular. If Ectopics (forget where they come from they are equally as irritating) it will be a regular beat, short pause and a heavy beat.

Tachycardia is regular fast beat as also is flutter.

[Tropicaltaurus in reply to BobD]

Thanks for the info 😊

[CDreamer in reply to Tropicaltaurus]

Know your pulse

heartrhythmalliance.org/pro...

[secondtry]

Sounds like you have asymptomatic PAF, good in that it doesn't stop you doing things but not so good as you may not be able to keep a record for your cardio appt as to how many times you had AF and for how long.

Definitely prioritise a private cardio appt, particularly if your partner is not well. Take a list of Q's and write down the answers before leaving the consultation room.

[Tropicaltaurus in reply to secondtry]

Thank you 😊