Hi, I was out gentle running, no exertion, proper warmup, and I had little notice of lightheadedness followed by an immediate collapse and out cold. I have had Afib diagnosed but have no feeling of my heart however it goes. I wasn't ill, dehydrated etc fully prepared for a light jog/run, I do mean slow 8mins/km, I run 3-4 times a week. Unfortunately I had a flat on face knee landing and was bluelighted and spent 24 hrs in A&E which was under the cosh. No cardio specialists on duty on account of all electives cancelled.Discharged now with a note to cardio to follow up. Note the tests they did ruled out a HA and stroke.
Has anyone any experience of this and the way forward as it seems a bit difficult to pin down?
Am I right to consider the possibility of Afib impacting BP to cause the Syncopy?
If you can specifically address this I'd be really grateful so I can be sure that I get the best outcome which at the moment looks like "unlucky could happen again".
Thanks in advance.
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Chinkoflight
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Unfortunately yes, I have had that unpleasant experience. It occurred during "fast" AFib episodes and "slow" episodes (with heart rates less than 100 per minute).
In my case it was caused by long pauses between heartbeats. All sorted now with a pacemaker.
Thanks Baba, that's really helpful to know. I have been told of one episode of Afib detected at HR110. My concern is checking out any consequences of Bradycardia extremes which is common in sleep and next day outcomes. So I will feel more confident having a knowledgeable discussion with the cardiologist who usually feedbacks.
Sorry to hear of your experience. Looking at your bio I see you had a Lynx monitor inserted. Do still have it if so that should give some clues. I collapse with Afib and svt. My EP team seem extremely keen to know if I pass out completely or not or keep some level of vague consciousness. Make sure you get to see your cardiologist as a priority. In the meantime rest and get a full cardiac work ip with your specialist before further activity. Wishing you well.
Hi meadfoot, thanks for checking back. I find it difficult to be succinct in posts and worry about a tendency to put too much info in! Yes I have a LINQ monitor but I'm aware it generated reams of data which is analysed by AI but still needs checking. On the one hand it's a clever device but it can also generate more work which is a challenge for a lot of teams I suspect. But your distinction between passing out and vague consciousness is spot on. I have had the odd dizzy spell in routine activity, not running, no pattern detected by me. But a momentary slow down, or even thinking about it always enables it to pass. On this occasion for about two seconds maybe three it was dizzy, light headedness then nothing and waking up in recovery position with a few people around me and some bumps and cuts.For me I need to find a work around so I'm not disabled by this new risk and can still do the things I want to do.
Interestingly one registrar in A&E commented on my cold hands saying this was also a symptom of Syncopy and having ruled out stroke and HA was saying Afib although of course he was not a cardiologist. Thank you again, really helpful.
I think your Lynq implantable will give you the answers albeit it taking a time for download and analysis. Its great if it does as without it it can take a very long time to catch whats going on. I am playing that very same cat and mouse game as I dont have a linq to capture issues, so wish I did.
I get the cold hands too as mine react the same as yours did and my feet especially are freezing cold. I am always extremely cold to the point of shivering when af related symptoms hit me.
Are you contacting your linq physiologists to highlight this episode. Heres hoping you get to the bottom of it. There is every chance you will given your implantable is there monitoring you ongoing. Best wishes. In the meantime please be careful with your activities until you have the all clear from your cardiologist.
Hi Meadfoot, yes I'm in touch now. Of course I was in hospital so Saturday data didn't upload!! My partner is insisting I get the sharp elbows out but our local GH is chaotic and in measures!
I agree re sharp elbows. My area is in special measures, where isnt these days it would appear, but if we dont push we get left behind sadly. Those with the loudest voices, as they say, sad but true. My inlaws used to sit and wait, indefinitely, much to their loss. I am with your partner on this. You need this info asap, its your heart not some drunken fall on a Saturday night, please put yourself in the strongest position to get answers. Good luck.
Get those elbows out. Although you've been checked for the big nasties passing out without warning is not to be ignored - not the least that you could've done more damage in the fall.
If you fail over and over again to contact anyone in the NHS who can/will help you, go through your local PALS service. (Patients liaison) They have proved very helpful to me, even getting appointments arranged where my GP had failed despite trying hard! It’s worth a shot anyway.
I have been close to passing out when in AF a number of times and recognising the symptoms …my face goes cold and l feel sweaty and blackness begins to decend, I lay down and raise my legs to stay conscious . Living alone out in the countryside I don’t want to risk losing consciousness.. In AF my BP is all over the place I can’t get an accurate reading but know it can plunge from high to low rapidly and I guess this might be responsible for my fainting episodes . When taking flecainide the first time around I felt faint frequently and passed out in the field with the dog . Luckily I had my walking pole and feeling the symptoms was able to slide too the ground without injury .I came around laying in a heap with my dog licking my face .I don’t like fuss or hospitals so haven’t made a thing about this to the medics who until recently have shown little interest in my AF anyway until I was referred to a different hospital for an ablation and treated by an EP with an interest in his patients .
Sorry to hear you are having this problem. Has anyone suggested you have a LINQ or similar continuous monitoring? In my case episodes were far apart to start with and happened without warning, even when in bed, I had no idea what was going on.
Hi Baba I have now had an ablation thank you and am at last being monitored after 8 months of almost continuous AF . I haven’t felt faint since the ablation.
Reading my LINQ patient info system I see the latest version has greatly improved analytic tools so now is also able to be used for detecting syncope. I would go to your GP and ask about a referral for a LINQ implant under the NICE guidance.
I wish on the cardiology front. Not possible to access cardiology advice yesterday in A&E so after keeping me in overnight and in the middle of a critical incident operating regime they discharged me anyway from A&E! I have an implanted LINQ recorder so the data is there although can be transmitted for Saturday because I was in hospital!! I know!
Sounds very familiar. My first syncope event triggered the emergency response. By the time they arrived I was back in sinus rhythm. A&E could find nothing wrong. Diagnosis was common faint.No meds.
Next event 18 mth was a repeat only with much more serious issues. Emergency response immediately identified AFIB, later confirmed in A&E.
And so the journey began loop recorder, pacemaker for better intelligence then RF ablation 3 years ago no AFIB since and importantly no bloody beta blockers.
My only reflection is the relative lack of understanding of the scale of AFIB if you don't present with symptoms which can easily happen you can have it working away in the background getting worse without knowing.
Thanks for this reply. It's what I suspect sharp elbows or not and is probably where I am. Trying to avoid sipping into the savings to pay for what will be a come in this week for a gold star service in my local GH and here's the bill!
me too. Long pauses on conversion to NSR to plus sick sinus syndrome. Pacemaker sorted it all. Still get AF episodes but much fewer and no syncope. Best of luck.
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Thank you Tracy, at the moment apart from email catching up I'm waiting for a call back on my NHS call answering queue number at the moment which I don't want to lose. I will call them when I've hopefully got my response from the EP team at the GH and my GP.
When I first started my AF journey back in 2014 I was having truly disabling episodes of AF with heart rate sometimes up to 200. I started getting frequent spells during an episode of dizzyness - like blackness creeping in around the edges of consciousness. Once it was caught on an ECG at my surgery and I was shipped off to hospital. I later had a pacemaker fitted. No more dizzy spells. Hope you get sorted soon.
Hi Rosemary, thank you for your reply. I have had the occasional dizzy spell which I've been able to manage my way through, standing still, sitting down etc but have never fainted. On this occasion the dizzy spell started and I thought my what to do, but then just collapsed. Came round in recovery position with concerned people around me, ie no time to safely get to ground. So very different to my severe stroke which was gradual enough to go to ground before I passed out. Glad your okay.
I have an elderly friend with permanent AF at a normal rate and few symptoms. And yet he has fainted three times that I know of, over the years, from his AF and, I guess its effect on his blood pressure or whatever. Indeed, his first awareness of his AF was very many years ago when he collapsed in his kitchen. It sounds a similar event to yours given that the doctors found no other causes while you were in hospital.
Thanks Steve. The difference I'm becoming aware of as I think about it and check the research is having a fainting episode whilst exercising, normally the heart is pumping so it's counter intuitive. But a heart attack was ruled out hence the question.
That’s interesting. At least your heart itself send physically sound so it seems to be an electrical issue. Could the exercise and high rate have triggered AF, perhaps? A cardiology assessment seems needed.
Initially I thought not, in that I was exercising but not exerting myself, the usual slow at a conversational pace light run. However, I have found an authoritative clinical guidance paper which describes perfectly a short heart stopping Afib that causes collapse type syncope without symptoms. Obviously I can't and try to avoid self diagnosis but it seems what one registrar in A&E was suggesting although he was at pains to say not a cardiologist. It prompted me to look it up and hey ho. But I now have to suffer A&E again although I'm here at their beckoning to see a cardiologist. Hopefully before they go home!
A registrar can be as good as, well maybe better than, a consultant in my experience. It depends, of course. You seem to being looked after. Keep us posted!
That's where this morning's research has taken me too particularly as I was exercising so unlikely the common syncope event which A&E investigations also agreed . Have you been offered any intervention. The response to my question seems to point towards a pacemaker.
Yep, the notice was served at 1.00pm when they called me back in saying a problem had been picked up! But because I shouldn't have been discharged without seeing a cardiologist I am now in an appalling a&e that makes Casualty look gold plated! Waiting to see a cardio.
I experienced a number of syncope episodes when in AF, both at home and once in hospital.
The Cardio nurse practitioner suggested I look at the site created by the team at Imperial College NHS Trust. I can no longer post a link, so please search for "stopfainting dot com" which contains information on why one faints and the steps one can take to avoid it. I found it very helpful
A couple of times I was in the middle of a longish walk, not very fast though! They also seemed to happen when I was either on the loo or heading towards it in the middle of the night
The worst was when I was on the loo in the hospital ward, jsut after getting Covid and going into persistent AF. I might have banged my head so they gave me a scan to check for bleeds as I am on Apixaban. Luckily all was fine
Thanks, helpful. I felt as if I was old man, fall on EDOXABAN, mandatory scan and x-rays for fractures, bleeds etc. They did reluctantly hear but I didn't trip fall and it wasn't the normal stand up , low BP , syncope event. But efforts to get cardiology to discharge failed. GH on a week of critical incident declaration and in special measures!
I was first diagnosed with AF following several episodes of syncope over 24 hours. The Cardiologist said they didn't know what caused the syncope but it sometimes happens when the heart tries to go back into NSR.
It stopped happening for a couple of years (I was in permanent AF) but then it started happening again (pauses of up to 19 seconds) and I got a pacemaker. OK since then! 🤞
If you don't have a BP device I would get one if I were you and would then take a reading before going out on a run and also to do short test runs to check you BP. Low BP is another reason for syncopy that can be ruled out.
Yep I do check my BP. I know my normal range. Because of my running my cardiovascular has improved and my BP is low and good. Also know what is elevated for me, but this is a tad below 140 systolic so not accepted clinically as low. I have bradycardia and I think this is possible related. Whatever I think it's not a run of the mill event, well it's a first for me. Thanks for the advice.
I'm sorry to hear of your troubles. In answer to your question, YES, I have had syncope. It was not every episode of Afib, but when I did have it, it was always during the onset of the episode when my HR would go over 200bpm. It would then settle down quickly. I never fainted entirely. I also have a LINQ, didn't want it at first, but in the end it is very liberating... no need to "prove" anything anymore!
I don't know if this would help you, but this process helped me each time.
> Breathing evenly, not fast, deeply.
> Pull in your abs strongly (not easy with the breathing deeply), and hold them in while breathing.
I learned this trick when I was flying small airplanes and doing spins and loops. Keeps the blood up in the upper body better!
I wasn't always in a situation (at work) where I could sit down immediately so this was very helpful!
Hope it can work for you and eventually that you don't have these issues- afib included.
Great if that happens I'll do as you suggest.. I have no sense of any heart events normal or otherwise. On this occasion no time to do anything momentarily aware then lights out. Never had a syncope event before.
I am not a medical professional in any way just an afiber so take what I say accordingly. I don’t know whether while at ER your heart was monitored or not and if so what were the results. I believe your Cardiologist will have you wear a heart monitor to check if you have any heart pauses for a longer heart pause could cause you to pass out.
Thanks for the reply. No it wasn't monitored continuously. I have a LINQ Implanted ECG recorder. It has picked up a 22second tachycardia event when I pressed the alert when sufficient consciousness had returned about 15 minutes after I collapsed. Unfortunately I had to alert the cardio team late this morning who then looked. It should have tripped a red flag, otherwise no point in having it fitted. Combined with not being seen by a cardio in all the time I was in a and E in spite of their request. Now I am in a&E again, called back by the hospital as I cannot enter Cardiology unless by AandE.
I have only briefly scanned the replies to your post, quite a few, so forgive me if I am repeating what has been said in another reply.
There is a EP in London who specialises in Syncope. I was guided towards him by the AFA team on this site few years ago just as covid kicked off and I had a consultation, although I don’t have the type of symptoms you do.
His name is Dr Boon Lim. On his website you will see his long list of credentials. My consultation was private. Quite expensive I’m afraid, even back then and I haven’t been back to see him for a number of reasons, none of them to do with him. He really knows his stuff and is eminently approachable.
Hi, thanks. That's useful to know. I have posted an update and things have moved on. My implanted LINQ device detected a significant tachycardia event. I have had a full review of the data and some preliminary routes of investigation have been identified. Exercise triggered syncope and tachycardia is quite specific and carries dangerous risks apparently. I think the relevant expertise is here. I'm awaiting admission from AandE . I did have to resort a bit to sharp elbows putting an email in along with concern about not picking up the event at the weekend and not until I made this written and phone prompt this morning. I want to make clear to anyone reading the link to exercise, it is not a reason not to exercise! My exercise since my stroke may have made me stronger in this event and certainly going in to surgery that will happen this week.
Good morning Chinkoflight, sorry to hear you have passed out, my own experience started on the golf course.
Began playing with our normal 'roll up' and after a couple of holes began to feel strange so decided to walk the next hole. The nex tee I missed and walked to go onto the fairway and last thing I remember was coming to hanging onto my trolley. Went back home and it took a good 3 - 4 hours to recover.
Again was joining a motorway junction and just passed out for a few seconds maybe 30 secs most. This happened on the hottest day of the year and as i did not drink much fluids was put down to hydration.
I n the end I have a pacemaker and AV node ablated which with a blood thinner seems to have sorted the issue of AF, the cause of my AF started when I dislocated my hip whilst walking the dog.
Now feeling quite normal and back to golf 3 x times per week, although at 78 not as much energy as before
Thanks for the helpful reply. I'm building up a picture of the suddenness and length of the event. My LINQ implanted ECG has a full tape of the event, one of the wonders of science. The Cardio team/A and E were under the cosh of a disfunctional unit at the weekend but got there act together yesterday afternoon and proceeded to frighten me to near death😂.
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