Newbie - Constant bradycardia afib/arrhythmia symptoms?

[Efka]

Hi! I'm curious if anyone has/had constant 24/7 bradycardia afib/arrhythmia?

What symptoms did you experience?

Short background, husband had an ICD implanted 6 of Feb and it has caused/triggered constant afib (reading medical research I now understand these procedures are known to in cases be pro-arrhythmic).

The ICD was a mere precaution as possible higher risk of cardiac arrest due to heart failure. No know afib previously or if there was it had no symptoms. No real symptoms of heart failure either. He has been bradycardic for many years, hard to say if due to beta-blocker and other meds or naturally but again that has never caused him any issues.

A cardioversion was performed 1 of March and the ICD reported he stayed in sinus rhythm for less than 24 hours.

Here's my quandry...

Since the ICD operation in Feb he is constantly:

- Breathless and has airhunger.

- Chest pressure like a vice and pain.

- Stomach muscles aches like after a workout.

- Can't really sleep nor doze, laying or sitting. Looks and sounds like central sleep apnea.

The only symptom that stopped after the cardioversion was a slight ad-hoc chest flutter

During his (short) time in sinus rhythm though nothing else changed. Should it have as he was no longer in afib?

The current cardio plan as of yesterday is pre-loading with Amiedarone and another cardioversion in 6-8 weeks time. I admit I'm not feeling high confidence and am rather frustrated.

My limited understanding of afib was that is't mainly attacks? Is it common to have 24/7 symptoms?

Any suggestions, ideas, advice most gratefully received.

Thanks, Eva

[Buzby62]

Hi, have a read of the information booklets on following link

heartrhythmalliance.org/afa...

I would start with AF Fact file and then FAQs

AF types

[Efka in reply to Buzby62]

Wow what a fantastic treasure trove of reference documents. Thank you so much! I’ve been “lurking” and reading here for a while but not come across these before.

I really appreciate what a supportive, and open minded, community you have here.

[Buzby62 in reply to Efka]

Once you’re in that site you can also use the Menu button at the top to navigate more information.

Best wishes

[JOY2THEWORLD49 in reply to Efka]

Hi

On looking up the procedure done, it is put in for RAPID H/Rate when meds don't work in bringing the h/rate down. So that doesn't sound right. OR your husband's heart stopped. SO it works to keep his heart beating.

Yes, questions to his procedure need answering.

Take care, JOY

[JOY2THEWORLD49]

Hi

Your reporting is confusing. Bra.... is AF.

I had Rapid and Persistent AF H/Beat 185 on Metoprolol. It made me breathless on any exertion! Monitor showed pauses at night. Night bpm is always 47avge.

I didn't want Metoprolol but it was put in my regime of meds.

Proved again but left 1 year 3 months. Banned.

Changed to Bisoprolol which is a better BB fr AFers. But @ 156 H/Beat day avge that wasn't CONTROLLING my rapid H/Beat.

Symptoms - Sweating uncontrollably. (3-4 cold showers a day). Having to rest on elevations, stairs or any exertion. Into bed to rest or go to sleep.

Now. A private heart specialist introduced CCB Diltiazem. But 120mg was best for me (360mg full daily dose). So m regime is

AM Diltiazem 120mg for control H/Beat. Day 60s bpm/Night 47 avge bpm with no pauses.

PM Bisoprolol 2.5mg for control BP. 123/69

No ablation/no cardioversion/ no anti-arrhymnic meds.... as ECHO shows abnormal heart structure.

It took 2 years 3 months to CONTROL my heart beat and AF.

I'm told I will always have AF.

cheri JOY. 75. (NZ)

[Efka in reply to JOY2THEWORLD49]

Gosh Cheri, I am so sorry to hear all that, you’ve certainly been through it before the right combination was worked out. I hope it keeps you stable and low symptom.

And I’m sorry for being unclear, I guess I truly don’t understand my husbands situation. Nor afib fully.

So he has had low pulse, bradycardia for years with no issue. He never gets a high pulse even now with what they say is constant afib after the ICD op his pulse doesn’t go up over say 65. He has never had any tachycardia instances.

Searching online for constant afib with low pulse I just can’t seem to find much or anything where I go aha that’s it, that fits.

I think I will have to try to see if we can speak with another cardiologist, we’ve just had another 2 terrible nights and the prospect of another 6 weeks or so is not appealing.

Thank you for sharing your journey with medications and symptoms it’s really helpful!

[JOY2THEWORLD49 in reply to Efka]

Hi

Tachycardia as I understand it is AF as it is low and IRREGULAR.

IRREGULAR is the AF sign if he was properly diagnosed with Tachy..

It appears one is better with RAPID to control than LOW.

But 65bpm is good then you move onto how you feel.

Does he wear a night Apnea OXYGEN appliance?

I know folks who do and it keeps their AF at bay.

Perhaps that is the road to check out. He's got to feel comfortable.

Also his 65bpm at night may go under 40 which is serious stuff with AF.

Please keep us posted.

Cheri joy. 75. (NZ)

[Efka in reply to JOY2THEWORLD49]

No one has assessed his breathing nor what I think might be nighttime central sleep apnea yet, again before the operation he was fine.

We’ve mentioned it several times up the hospital but they don’t seem too bothered or maybe just focussed on the new afib for now…

I might have to speak with them again as I’m not sure if another 6+ weeks but so little sleep is sustainable.

His device is set to pace if he goes below 50 bpm so guess that in theory is a good thing.

I will share how we get on.

Thank you again for taking the time share further and for caring.

Hugs, Eva

[bean_counter27]

Why do they think hubby's symptoms are caused by AF?

AF symptoms and their impacts vary significantly from one person to the next, ranging from asymptomatic all the way through to debilitating. Approximately one-third of people with AF are asymptomatic.

I'm not a medical professional but I would question whether symptoms that persisted while he was back in sinus rhythm are caused by his AF.

Given the symptoms commenced after the ICD implantation procedure, I presume you've already quizzed the doctor who implanted the ICD about whether it could be something to do with the procedure or the operation of the ICD.

I hope for both your sakes you get to the bottom of it ASAP. It sounds horrendous.

[Efka in reply to bean_counter27]

Thank you very much I so appreciate your thoughts and sharing, and actually I guess this is why I asked here - I am not convinced and my gut says issues with his leads and/or placements (2 leads, right atria and right ventricle) after researching medical papers.

Alas the cardiologist whom we have not formed a relationship, nor trust with, brushed us off and straight went with, as his ICD recorded data shows arrhythmia/afib, that’s what it is hence Amiodarone and second cardioversion upcoming.

I’ve spent two nights thinking and I think I will try to speak to a British Heart Foundation nurse and I will call the hospital’s arrhythmia nurses whom I’ve spoken with several times and see how and if it is possible to see a different cardiologist.

Thank you again, and I agree, not sure how we could stay like this for 6+ more weeks.

[Ppiman]

I really can't think you'll get an answer without further tests and with the NHS in its current state, that might not be easy. I was given a stress cardiac MRI after my ablation owing to continuing chest discomfort. A private one costs a lost, though (well over £1000, but maybe worthwhile).

Steve

[Efka in reply to Ppiman]

Ouchie yes that would be a lot of money! I hope your stress MRI helped shed light on your chest discomfort?! And that the ablation did its main job.

We are feeling completely shut down by the cardiologist in question, it was a typical I’ll talk at you consultation with no physical examination. I’m trying to “pluck up the courage” to call back a lovely arrhythmia nurse and see how/if we could get to speak with another cardiologist… my husband is though very stoic and doesn’t want to cause any fuss.

Thank you very much Steve!

[Ppiman in reply to Efka]

I think your husband’s case, like many that aren’t “straightforward AF”, is made more complex by his left ventricular issues. The underlying cause of heart problems is often varied and complex, whereas the treatment options are far more limited. Understanding what is causing what, or making it worse or better, seems to be often unknown with treatment being “the best guess”.

My feeling is that your husband’s condition will improve over time as these things tend to do, once his heart settles to the new device.

Steve

[Efka in reply to Ppiman]

Thank you Steve for your positive outlook much needed right now!

And yes you are right, they are complex issues and ultimately what counts is quality of life - here’s hoping.

[Buffafly]

Hi Efka, Speaking from experience I think the problem might be bradycardia + AF. My AF episodes are sometimes very slow compared to ‘normal AF’. If I have slow beats interspersed with a short bunch of quick ones all is fine as my circulation is working fairly ok I guess. However a run of beats much slower than normal HR (60) can cause breathlessness and a feeling of pressure in the chest. The big problem with that theory is that the pacemaker shouldn’t allow your husband’s rate to go below 60? Maybe the AF confuses it. Otherwise the AF may have caused your husband’s heart failure to worsen.

I would phone the nurse available on the BHF website and maybe post there as well. And definitely change your cardiologist if possible even if you have to start with a private consultation though you are entitled to a second opinion.

Best wishes ❤️‍🩹 please let us know how you get on (in a separate post so we don’t miss it)

[Efka in reply to Buffafly]

You are so kind thank you! And very interesting to hear of your “episodes” that certainly sounds more like what he Might be experiencing.

He’s set to pace at 50 bpm. He was often around 45-50 over the last few years with no symptoms.

Hmm yes you are right, I think I can’t let it go I need to try to get more medical advice.

And I will share an update… here’s fingers crossed! Thanks again

[Singwell]

I know very little about ICD but I do know from a retired medical friend that he had issues with his (sorry can't recall the details) and it gave him horrible breathlessness and 'heart failure' type symptoms until it was replaced/reset. AF should not be giving crushing chest pains as you describe or the breathlessness. Not usually. My friend is now fine BTW.

[Efka in reply to Singwell]

Ahh now that is interesting! Thank you very much for sharing. And for the positivity.

Think this is my problem, I’m not familiar with afib enough to clearly say if these are common (and sometimes constant) symptoms.

My gut has from the start said either device settings or lead issues (placement or nerve activation).

I shall dig further…

[Efka]

Firstly I am so pleased your afib seems to keep away at the moment. And that a pacemaker is is the future.

And that interesting and helpful thank you I’ve found so little on afib in bradycardia.

My husband is always between 45-65 (as in for resting or normal activity, I don’t know what the pulse is on heavy activity I’ve never actually checked it).