Length of time in AF

[Dogwalkers]

Hi should I be worried my heart has been in constant Af since September . My heart rate goes from 35 bpm to 182, I wear a fitbit so I can track my heart rate. I'm on medication to slow my heart rate I take maximum does as well as blood thinners. I worried that my heart is being damaged by this constant AF.

[Jalia]

Firstly let me say that I'm not medically qualified but I've had a great deal of experience of AF , it's treatments and tribulations.

However I most certainly would not be happy to be in constant AF with rates reaching 182bpm. Have you actually seen a cardiologist or better still an EP ( Electrophysiologist ie cardiologist specialising in arrhythmias) ?

My feelings are that you need to make your GP/Cardiologist aware of your situation.

[mjames1]

At a minimum, you want your heart rate controlled when in afib. 182 bpm is not controlled at all, unless you are exercising intensely.

Given this you either need an adjustment in your medications and/or a rhythm control strategy with anti-arrythmic drugs and/or an ablation. The best person to see about all this is an ep, not your GP or even a cardiologist. The longer you stay in afib, the less chance you will have to get out of it. And the longer you stay in afib with an uncontrolled heart rate, the more chance you may do damage to your heart over time.

Jim

[JOY2THEWORLD49]

Hi

My guess that a CCB Calcium Channel blocker would control your H/Rate. I was way up at 186 on Metoprolol and 156 on bisoprolol avge Dayrate. The private man found me on rest in 120s.

I had rapid and persistent AF H/Rate. BB Metoprolol was hopeless and made me breathless with no energy and a 24-H/monitor showed that it gave me pauses at night. My low avge Night of 47 regardless of no med or any med.

I take Diltiazem 120mg AM for rapid h/rate

2.5mg Bisoprolol PM for BP

And PRADAXA 110mg x twice

It sounds like you are not controlled through the AF.

Best to let your H/Specialist know. I finally saw an interested private H/Specialist.

I am happy with 110-130 / 69. and now 60s H/Rate Day.

It is imperative to control because the stress on your heart (sweating and fatifue), no anaesthetist will operate on you. Do you need to loose some weight. Waist male 30" and woman 35". I lost 6 kg over last year and my earlier controlled level was 88-96 but its slid down to 60s and I feel heaps improved in walking on elevation surfaces.

I'm glad that you are monitoring your levels to manage your own health and asking the forum means you are interested to get some action from your H/Specialist. GPs only put up dosages or reduce them.

cheri jOY. 74. (NZ). HAPPY NEW YEAR from NZ

[DevonHubby1]

Wife has been in persistent AF since March but HR was never as high as yours. GP tried increasing Bisoprolol dose and then switching to Atenanol but that didn't work. Got urgent referral to cardiologist who switched her to Nebivolol which is doing a good job of controlling HR.

Push for refers to cardiologist/EP and if a long wait try calling private consultation.

[Thomas45]

You should try not to worry about anything, as worrying is not productive. First you need to see your GP to be referred to a specialist, an Electrophysiologist is better than a Cardiologist but you may be referred to a Cardiologist first. Your GP should be able to tackle your high heart rate. The drawback if getting a GP appointment is that you won't necessarily tin AF when you go.

Alternatively you could go to A&E next time you have AF with a high heart rate. It could be, of course, that your Fitbit is showing the wrong heart rate.

.When I told my GP that my heart went haywire from time to time, she advised me to go to A&E the next time it went haywire, which I did, and was from there referred to a cardiologist.

[Dogwalkers]

Thank you Yes I've done all that I'm on medication and I've been to hospital several times when my heart rate was over 180

I've seen a cardiologist and on Friday I'm having a cardioversion although everyone I've spoken to says that they either didn't work or that they didn't last for more than a couple of months

I'm really worried that my heart is being damaged by all this I'm still young and fit apart from this but I'm now tired all the time

[Jetcat in reply to Dogwalkers]

I’m sure Iv read you have to be in permanent uncontrolled afib for a long time before any damage can occur. ?

[Ducky2003 in reply to Dogwalkers]

The first cardioversion I had lasted 4 days but subsequent ones longer. Current one will have lasted 2 years in April, all being well 🙏.Any chance to get you out of AF is worth a bash as yes, prolonged AF can cause other issues. I would have a chat with your EP about possibly taking Amiodarone for few weeks before the cardioversion to help the heart hold nsr following it. That's what has helped me.

Just my non medically qualified opinion but I'd take a cardioversion every time its offered.

Best of luck.

[Thomas45]

Thanks for the additional information. Rereading you original post you said you are "in constant AF" and that your heart rate goes from 35 to 182. If your heart rate goes from a low rate to a high rate it indicates to me that you do not have constant AF, but paroxysmal AF. You now are worried about the effect on your heart. You should voice your concerns to your specialist, and have echocardiograms from time to time, effective ultrasound scans of your heart to see if it's affected by your AF.

[Teresa156 in reply to Thomas45]

Hi Thomas45,

When I have Afib, during an episode my HR can go from the 180s and then do some beats in the 50s and then go back up to 180s ( according to my applewatch). The joys of an irregular, fast heart rate I think. So it can in fact mean that this lady is in constant AF unfortunately at the moment abd not reverting back to NSR as in PAF.

[Singwell]

That's quite a range of BPM which sounds rather worrying. Must also be unpleasant and disconcerting. It is possible to have AF at quite low rates so I don't know if we can say with assurance that therefore you're not in persistent AF. But if you have readings, I am sure someone medically trained can give reassurance on that.

I second that getting an echocardiogram is going to be important so that your heart morphology can be checked.

[En85]

I've been in persistent since at least March 2023 (I didn't know when it started) until 4th August 2023 and first cardioversion lasted 3.5 months. I had another episode and because I had this time all the information I jumped straight from A&E in UK to a flight and to the emergency abroad where I knew I would receive cardioversion straight away. I had since a 24 h holter and an echocardio and luckily is still all fine and great for an ablation.

This is to say, probably nothing happens but it's true it's not good for your heart and not necessary to pass months in afib, so my suggestion is to do everything in your power to get one asap (this is what I would do). The cost privately of a cardioverision is between 800-1500£. If I could go back I wouldn't have let my heart stay in that situation for so many months.

To complete, I'm very young (diagnosed at 37), very fit and no other health issue, my blood comes always back spotless. If you have the strength and possibility fight back 💪

Best of luck!

[Teresa156]

Hi Dogwalkers,

when you recently saw the cardiologist, did they not say that your HR was too high?

What medication are you on the highest dose of? It seems like it’s not working for you.

I wouldn’t be happy to be at that type of high irregular rate for this length of time. Does your GP know you are at this high rate all the time now? Do you have an arrythmia Nurse at your Cardiology Unit at your hospital that you could call for further advice? I would tell them how bad you are feeling.

If possible, could you try and arrange a private consultation with an EP as they are best placed to handle your problem in the long term. They are about £250 and you would get seen within a fortnight.