Scan results

[Jarvo977]

got af in august and lv was 35 percent.finally had mri results been waiting since November. It says ejection fraction is 51 percent what does this mean . Thanks

[BenHall1]

Hi,

This definition below is from BHF website. It is a website you may wish to explore.

"your doctor may talk about the ‘ejection fraction’ of your heart. This is to do with the amount of blood squeezed out of the main chamber of the heart with every beat. It’s usually measured as a percentage – over 50% is considered normal. Your ejection fraction is measured from an echocardiogram".

[CDreamer]

I would be very happy with that number as it means your heart is doing a good job at pumping oxygenated blood around your body. Too high a % is often as bad as a low figure.

Just a warning though - EF fraction on it’s own is only an indicator as to the health of your heart.

[Ppiman]

It means that while you had AF, and more probably because of the racing heartbeat this caused (rather than being caused by the AF itself), the efficiency of the two pumping chambers at the bottom of your heart, the ventricles, was reduced from their normal fraction of 50+% to much lower. Now, your heart's efficiency is back to within the normal range and you should be feeling altogether much better.

When the chambers at the top of your heart, the atria, are fibrillating (i.e. twitching chaotically instead of pulsing regularly), the bottom of the heart, the two ventricles, continues beating as regularly and normally as it can. It often cannot fully ignore what is happening above, however, and its beat becomes 'irregularly irregular" and, sometimes, too, it races above 100bpm. To help this, a beta-blocker is usually prescribed, which slows down the heart rate, but doesn't, in itself, stop the AF happening up above.

Once the racing has been slowed, the AF can be caused to settle, however, so a beta-blocker is often the only treatment needed, as, so far, in my case (along with an anticoagulant to prevent blood clots which AF can bring about).

Of course, the beta-blocker will continue to slow the heart even without AF happening, and whilst this often seems to prevent the AF starting up again, it might also cause side effects of its own, at least in a minority, who cope less well with their unnaturally slowed heart rate.

I have read that some people cope well with a reduced ejection fraction, whilst others feel very poorly. It is this latter group who are often given drugs that work on the AF itself (anti-arrhythmic tablets) or are offered a catheter ablation. Your own EF (a measure of the amount of blood pumped out in each contraction) might have been higher in the past, so although 50% is now normal, for you, it might be on the low side and could still bring symptoms in its wake. This is likely why we all can have different responses to AF and to its treatment.

Steve

[Pommerania78 in reply to Ppiman]

So you think a racing heart CAUSES Afib, rather than the other way around? Thanks.

[Ppiman in reply to Pommerania78]

It’s only from what I’ve read. And the answer is both.

So called “adrenergic AF” is said to be a common “type” that is thought to be triggered when adrenaline and other hormones are released into the blood stream by, for example, by exercise and emotion. For some people, this is said to set the atria to start fibrillating. A beta-blocker prevents the heart from beating as rapidly and forcefully in response to such provocation as exercise and emotion, and, by this means, it is thought, can stop the AF from beginning.

That seems to be what I experience taking 1.25mg bisoprolol daily, which slows my heart a surprising amount. I wish it stopped the ectopic beats, which carry on regardless (and which tonight are awful).

Steve

[Pommerania78 in reply to Ppiman]

You know, before this forum I had never heard of bisoprolol. That doesn't necessarily mean much, but I think Metoprol is more common in the United States. Thanks for your reply.

[Ppiman in reply to Pommerania78]

You're right. Each country seems to have different "favourite" drugs. I gather that in New Zealand, doctors prefer nebivolol, which acts a little differently from metoprolol and bisoprolol. In the UK, bisoprolol is the preferred first choice. I think metoprolol is once a day dosage because it is supplied in a slow release formula, whereas bisproprol is once a day owing to its longer half-life. I think they both work pretty much equally well.

Steve

EDIT: It seems I read wrongly and that, In NZ, metoprolol is the choice.

[Pommerania78 in reply to Ppiman]

Yes, metoprolol is once a day and is what they call "extended release."

[JOY2THEWORLD49 in reply to Ppiman]

Hi

Wrong.

NZ introduces metoprolol at anyone experiencing a stroke. When metroprolol did not control my heart rate, I was changed to bisoprolol. The hospital heart specialist stated that bisoprolol was better for those diagnosed with AF as it doesn't interfere with the exchange to oxgenated blood.

Earlier year I was given an Ace Blocker with hypertension. I coughed and coughed with Inhibace (spelling). I was changed to Metoprolol. 47.95. But it was doubled and I could not breath.

Again I was prescribed with the stroke with AF. 3 x 25.75 and I was breathless on any exertion. (A year later given a 24-hr heart monitor. It showed 2 second pauses at night (47 avge bpm). H/Rate day 185 avge.

Bisoprolol showed no pauses but still no control @ 154 avge H/rate Day and 47avge Night.

Both these showed control of BP. But Heart Rate is so important as well.

Looking back I should have had CCB Diltiazem as H/Rate was No.1 problem. AF Rapid and Persistent. Surely that was the worse symptom.

So low dose of Diltiazem 120mg AM brings me down to 60s H/Rate. Night stays at 47avg.

Low dose of Bisoprolol 2.5mg PM brings BP down slightly to 110-130 / 79.

And research ?s whether AF patients should be given Beta Blocker e.g Metoprolol or Bisoprolol.

cheri JOY. 75. (NZ). Yes NZder.

[Pommerania78 in reply to Ppiman]

What do you think causes these ectopic beats? Thanks.

[Ppiman in reply to Pommerania78]

I don't think anyone really knows what happens. I have read that all heart cells have the ability to set off a heartbeat, and, for some reason, that happens when "rogue cells" change from doing their job contracting, to sending off electrical signals of their own to set off an ectopic beat. If these cells are at the top chamber of the heart, the resulting beat is called a PAC (i.e. premature atrial contraction), if at the bottom, they are called a PVC (i.e. a premature ventricular contraction). The effect of the beats is to create a feeling of palpitations.

Steve

[JOY2THEWORLD49 in reply to Ppiman]

Hi

Mr Ppiman.

Looking into inflammation and hyper-activitivity I remembered my Urogist saying that the blood in my urine was normal after a day of competitive bowling. Why, I asked? He said muscle become inflamed and bleed. It ends up in the urine.

So is this the explanation to AF in athletes?

On low BP could this be caused when ablation - scarring of the heart occurs.

Just my thinking.

So in low BP ablation can lead to a pacemaker fitted to take over.

Seems to me is to be active in moderation. Whilst some push it to the extreme and later are being diagnosed with AF.

cheri JOY. 75. (NZ)

[Ppiman in reply to JOY2THEWORLD49]

I've read, too, that the deaths that tragically and rarely occur in footballers, say, might be the result of the current macho male trend to be hyper-fit and to push the heart too far into AF. Also, some people have undiagnosed heart issues that they might have been born with.

Steve

[JOY2THEWORLD49 in reply to Ppiman]

Hi

Yes.

I researched NZ meds BBs on my computer it says metoprolol highest at 75%.

Then Bisoprolol next and it explains it is used on ASTHMA patients or those with negative breathing systems risks.

Go into BPac nz.org - BBs

Nebivolol is not listed at all.

May be Australia, perhaps.

cheri JOY

[Ppiman in reply to JOY2THEWORLD49]

Somebody mentioned it on here ages ago. It seems well liked by those who take it but I think it’s pricier,

Steve

[JOY2THEWORLD49 in reply to Ppiman]

Hi

I would agree with the Cardiologist that any heart unusual beats e.g. flutters would be frightening to say the least.

My Cardiologist - all of them actually, cannot believe that I have never had flutters, palpations or pain. Mine were excessive sweating and having to stop walking etc. My ribcage is 'bad' said the spine radiography specialist. Each side - one out and one in and heart has been pushed to left giving it plenty of room.

Me in my bikinis in Crete up close with a donkey after walking through the pass shows my unusual rib cage.

But I recall that I had flutters under stress in my 30s. I never did tell anyone. Stress was solved.

cheri jOY

[Ppiman in reply to JOY2THEWORLD49]

Happy times in Crete, I guess? We loved our holiday there. The Greek people are surely amongst the friendliest in the world (second only to New Zealanders, I reckon!).

Steve

[Ppiman]

Hi. I have had ectopic beats throughout my adult life but they have become much worse since my ablation for atrial flutter in 2019. I have also had several "panic attacks" during a part of my life, which were, back then, put down to anxiety. Whilst some of those occurred during anxious periods, the very first and most other didn't and I had none during some of the most stressful periods, more stressful, I imagine, than most people ever suffer. They all came out of the blue. I have now been told by a cardiologist that they might well have been misdiagnosed and, instead of being "panic", were brief episodes of arrhythmia. Of course, I shall never now know. I do well recall that my late mother also complained a good deal "flutters" as she called them, but they were never diagnosed. I have always suspected they were similar, so I suspect the cause of mine is an inherited trait, i.e. genetic.

Since 2019, I have had various scans, including a "stress cardiac MRI" and I was told that these all showed a sound heart but with a "left-branch bundle block". This is another conduction issue, and might be related, although I was told it wouldn't cause the ectopic beats, atrial flutter of AF that I have experienced. My GP, however, does tend to think this is responsible.

I wish I knew!

Steve