Good morning all,I've had some rather interesting observations over the last few weeks that I would like to share.
As background, I had an ablation in July which helped me reduce my Flecainide dose from 2x100 to 2x50mg per day and reduced my Afib episodes to about once per week. My resting heart rate has always been around 55bpm.
About 4 weeks ago I started to get lots of ectopics with no apparent trigger. I also had my regular weekly Afib episode. My resting heart rate was normal for me, 55bpm.
A week later my resting heart rate became around 77bpm (and has remained at this level), the ectopics disappeared and for the last 3 weeks I didn't have a single Afib episode. Exercise induced the ectopics but they subsided quickly at rest. I stopped taking the Flecainide 2 weeks ago.
This morning, on waking, my heart rate was 56 and I was in Afib for the first time in 3 weeks.
3 hours later my heart rate is now 77bpm and the Afib has disappeared. Still not taking Flecainide.
It would appear that my Afib is associated with a lower heart rate. Ectopics during exercise is a new phenomenon for me.
I haven't spoken to the EP department about this yet but, with some very fortunate timing, I was put on a 6 day holster yesterday so hopefully I can have some meaningful conversations with them soon.
You guys are getting advanced access to the information ahead of the EP team as I value your thoughts and observations and hopefully they can help me in my discussions with them.
Cheers,
Magoo
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I think it has something to do with the heart not detecting the normal beat and will try to restore it with what is called an "escape rhythm". Perhaps we see this as extra beats.
Thanks, J21 It would appear that the character if my Afib & ectopics and the general function of my heart has changed rapidly over the past month. Hoping this is healing, even 6 months after my ablation, and not things getting worse. Although if things have deteriorated the timing is spot on. I had a CT contrast scan of my heart on Monday as well as being given a 6 day holster yesterday so if anything is majorly untoward I would hope it gets spotted.
Only had that single, short lived episode of Afib today, although I've had 2 occurrences of flutter today (according to my Fibricheck app) which are normally very rare for me.I'm supposed to hand my 6 day monitor in after 4 symptomatic episodes. I won monitor bingo today, Afib, ectopics and flutter X2 and feel short changed only getting one day out of it.
I guess that the effects of the ablation or the drugs are causing this. I also get lots of ectopic beats but not especially associated with exercise. Are yours PACs or PVCs? If the former, then I've read studies that suggest this can portend later occurrence of AF; if the latter, with a healthy echocardiogram, then studies suggest these to be benign. In the presence of existing heart disease, then the PVCs might be linked to that and, as a result, might be of more concern.
Don't know yet if they are PAC or PVC. I have read that PVCs maybe related to cardiac arrest during exercise so I'm not venturing out into the wilds on my bike until my test results come back and I've spoken to someone.
I think - from what I read this morning - that is only when there is pre-existing damage or atherosclerosis and the like. There seems to be no effect on a healthy heart as shown on an echocardiogram.
this is a theory I hold. Not in every case but I think it could be why endurance athletes get it because they have lowered their resting heart rate. Mine is naturally very slow 44bpm resting heart rate. In my late fifties I developed paroxyl afib with no known cause. I think (with no medical knowledge) the two things could be related
Because the Afib had abated, there was a suspicion from my EP in the past that it might have caused me to get flutter and it affects my eyesight. Woken up by Afib at 5am today so popped a Flecainide that successfully stopped it.
Before my ablation I was put on flecanide. Although it may benefit some, others not so much. For me it was terrible!! Of course I stopped from taking it as well. Besides lowering my heart rate, I felt as if life was being drawn from me. I also had everyday throughout the day, tightening in my chest. If you have read about flecanide you will see that it too can actually cause an arrhythmia. But once again I state, that for some people it has done them good. But I'm not one of them... Blessings!
I'm having terrible flutters and ectopic beats most of the day. Spoke to cardiologist he didn't seem worried at all , said just got to live with it . Yesterday I went line dancing felt awful. Chest uncomfortable not beats but wobbly and fluttering all the time . On Bisoporol 5mg twice a day plus edoxaban and 400mg atorvastin. Had heart attack and stent fitted 10 years ago. But how do you cope with the ectopic beats constantly?
That's not a great response from your cardiologist. He might be of the view that because the ectopics aren't going to kill you then he's happy but they are affecting your quality of life. I think you should go back and tell him how they are seriously impacting your life.Lately ectopics are worse for me than Afib
Hello I have had on occasion stretches of low blood pressure which prompted a call from my Dr, telling me to stop taking my BP medication as low blood pressure can cause afib episode's which I never knew and since stopping I can go 7-10 day's without afib as where it used to be like clockwork 2-3 day's afib free then 24 hours in afib then stop, I was like this for years but now my brain has less of that foggy feeling and more relaxed. I too like you have HR around 44-53 but has never caused me to go into afib, in fact my cardiologist says not be too concerned about the low HR. I am seeing her this Monday and I will ask her if it can cause afib episodes.
This was eventually diagnosed as my type of AF and Pace and Ablate was recommended which I reluctantly agreed to and am off all meds accept anticoagulants and blood pressure and no AF since.
I have associated the onset of my AF episodes with unusually low heart rate. And my usual heart rate itself is also pretty low at around 40-50 bpm. So, I echo some of what has been said already about vagal tone, escape rhythms, night-time, and post-exercise onset etc..
However, in the case of idiopathic or 'lone' AF, I am inclined to think there is much more to the 'substrate' that sustains AF. And in my case I have found it useful to embrace diet change and attention to electrolyte balance.
I think it is no accident that a lot of people who get lone AF are people one would ordinarily deem to be very 'healthy'. And part of the problem is no doubt that we are the ones who have heeded blanket medical advice e.g. to cut down on fat, cholesterol and salt - to a fault.
It all depends where you are starting from. Cholesterol is essential to many hormones, and if you do not eat it your body will make it. Whereas, burning fat is in most ways more natural and preferable to burning carbs. And an acute deficiency in salt is at least as detrimental as a superabundance - just less likely, to a medical turn of mind, on the standard western diet.
My diet is now paleo-keto, which at the very least cuts down on carbs. And I am inclined to think that many of my problems (and my AF diagnosis 15 years ago) were down to low sodium (high potassium) and progressive stretching of the atrium, unaware of the problem.
It's all connected. I don't just have low heart rate, I have low everything, except cholesterol which is elevated. And a couple of generations ago the latter would be counted a prima facie case for suspicion of hypothyroidism. However, thyroid issues are not well handled today because of widespread medical ignorance and the prevalence of TSH and T4 testing (rather than e.g. testing for the active hormone - T3).
It happens that after 15 years I found by investigating this route myself that I have a common (DIO2) polymorphism that inhibits conversion of T4 to T3 in cells - like cardiomyocytes. Who knew? Which may be relevant...
No medic would be likely to find this out, even if it occurred to them, in the normal course of demarcation between cardio and endo specialisms and given the proclivities of the two.
So, it is worth reviewing your thyroid and adrenal status and considering the roles of cortisol and aldosterone. The latter has exactly the opposite action to atrial natriuretic peptide (ANP), whose activities are dictated by blood pressure and atrial stress.
As your drug of choice is flecainide, a sodium channel blocker, then its efficacy is probably related to sodium-potassium homeostasis. And you would likely not be on it at all if you had any structural cardiac or haemodynamic problem, because in its earlier incarnation as Tambocor it killed a great many such people and these are contrary indications for its administration today.
Unfortunately, the pipeline for antiarrhythmic drugs in development is sparse and unpromising, and surgical intervention is not uncontroversial in idiopathic cases of AF (like dealing with a fire by knocking off the alarm to my mind). So, it may pay to follow your own intuition about what lays you open to episodes in the context of your wider exercise-health, endocrine, and parasympathetic nervous system status.
In my experience you will not get much help with these endeavours from the mainstream medical establishment - for all the patient effort and inconvenience of Holter monitors, I have never seen a cardio give more than a nano-second to the results.
And the real risk for lone AF sufferers is that out of understandable desperation for a fix we are shoe-horned into some industrial strength solutions that allow medics to 'tick that box'.
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