It’s a saga but will make it as short as possible!
I have paroxysmal AF, big nuisance but I don’t usually have fast episodes any more, take Apixaban anticoagulant so I put up with it. On Friday afternoon while quietly looking at a book an episode started. As usual pretty nasty for first two hours but then calmed down so I was able to sleep. However, when I took a Kardia reading I noticed that my strip looked quite different to normal so I thought about a possible trip to A&E on that basis but couldn’t be bothered. Sinus rhythm returned on Saturday with a determination of Wide QRS - also new. I felt poorly all weekend and even more so when DrGoogle and helpful poster here informed me I had developed Left Bundle Branch Block since my last episode of AF but since I hadn’t done a recording since March I didn’t know when. On Monday I phoned my GP surgery and asked for an ECG, booked for Tuesday pm, a few hours after which I got a call from a GP telling me to go to A&E immediately. Turns out LBBB mimics an MI so a blood test is necessary to tell the difference. I had a very good experience in A&E where the doctor I saw was very pleased to be able to see relevant Kardia tracings but it wasn’t as helpful as it could have been. No sign of heart attack fortunately.
So being sent back to cardiology to see if my minimal AF treatment needs upgrading. Dr Google tells me that the gold standard treatment is a pacemaker like CDreamer’s but I very much doubt that will be offered.
So, don’t be obsessive but regular checks are good…..
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Buffafly
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Dr Google tells me that the gold standard treatment is a pacemaker like CDreamer’s but I very much doubt that will be offered.
I don't know the context of "gold standard" that you found, but a pacemaker is certainly not the standard treatment for either paroxysmal afib or LBBB. In fact, LBBB often requires no treatment.
If a LBBB is present with other arrhythmia, such as AF, or structural issues it most definitely usually does need a pacemaker. A biventricular pacemaker is inserted to keep the ventricles beating in sync.
My LBBB is combined with multiple other issues and it causes breathing and lifestyle issues, and a decline in EF.
If LBBB is present but only on exertion and increased heart rate (as an example >125bpm) it may not cause issues and may not require treatment. Buffafly obviously has more than just a LBBB.
We all have different cardiac concerns, different health histories and different outcomes.
My LBBB is combined with multiple other issues and it causes breathing and lifestyle issues, and a decline in EF.
And that's why a pacemaker made sense for you. But many are asymptomatic with LBBB and have no structural issues and certainly do not require a pacemaker, even if they have atrial fibrillation. It's case by case and again by no means the "standard" treatment.
Maybe not, but my point was that LBBB, even with afib, doesn't uaually require a pacemaker --nor would one be a good idea -- unless certain symptoms present and/or structural heart issues. Case by case.
I sometimes wonder whether it is possible for you to concentrate on the main point of a post without seizing on some side issue to start an argument about? Btw I got the information from the Cleveland Clinic website and the British Heart Foundation and of course it only applies if treatment is actually needed.
Thanks Jim and I understand what you’re saying but I do think you may have focussed on a point that didn’t need such a focus. There are many broad statements made during the course of discussions in here, and in real life. I’m sure Buffafly knows what they meant and everyone else took it in the context and spirit of the conversation.
We will have to agree to disagree on that one. I thought it was an important point to clarify and in fact, it was the concluding point in the OP 's post. If you disagree with what I said that's fine, but please don't tell me what or what is not important to comment on.
Sorry to hear this but good for you being on the ball! I think CRT seems to becoming a lot more common, several posters mentioning it in the last few days. Very glad got mine and if it is thought appropriate I’m sure you will offered it as well.
I had a few scares with suspected MI but always came back clear, thankfully. 😅
I got the impression the GP was more panicked than I was! I was just annoyed about having to go to A&E after all. The A&E doc said my heart had remodelled.
Further research says that CRTs are becoming more popular because basic pacemakers have the same effect as LBBB ie one ventricle beats slightly before the other leading to heart failure in time.
Glad you got checked out Buffafly and that your experience of A&E was a positive one. Hope you soon feel better and make sure you get gold standard whatever the treatment is they offer you!
You say you're taking apixaban, and I gather that you're in the U.K.
Is apixaban generic Eliquis?
Is it not terribly expensive?
I ask because I am now researching what I will take to reduce clotting possibility. In the U.S., Eliquis costs around $500 for 30 pills.
I have read that the U.S. FDA has approved a generic for Eliquis, but that it won't be sold in the U.S. until April 2028, on account of patent protection.
Yes, Apixaban is generic Eliquis. The US system is screwing patients over because the generic drug is available even in Canada now, and is quite cheap.Could you perhaps pop over and get your prescription filled here?
Yes, there are ways for a U.S. resident to get meds from Canada, without going to Canada. It's complicated, though, and a bit costly, as one must get a doctor in Canada to work with a doctor in the U.S. and a pharmacy in Canada. And apparently there are bogus actors in this charade that provide fake or inferior meds. And apparently it's hard to get people to help with this, as they are afraid of breaking laws.
A person on Medicare in the U.S. (like me) can enroll in Medicare's Part D, which can bring large discounts. Lucky me, I disenrolled from Part D during its disenrollment period because I was paying premiums that did not bring discounts on cholesterol meds.
In fact, with insurance, those meds cost $150 for 30, whereas "going naked," the cost was $40.
I can re-enroll in Part D in December, and then get a discount.
This is one of the ways that America is a terrible country for many of its citizens. I hope the rest of the world appreciates our "subsidy," if you will, that is providing by us paying for years and years the full asking price of meds that are generic for y'all.
As for popping over, I'm a two-day drive from Canada.
I have received a number of different generic versions of Apixaban in the last few years here in the UK. Initially, it was always the branded Eliquis. I'm sure the pharmacies in the UK are required to provide the cheaper generic version, if at all possible. That's fine by me as I haven't encountered any differences.
Of course. we are unaware of the actual prices paid for our drugs on the NHS. I understand the US drug companies are often very unhappy with the NHS's negotiations!
I take eliquis and have recently been getting it much cheaper by using GOODrx , on line coupons used at my local drug stores, ( site lists the prices at all my local pharmacies ) Last refill was $120. for three months. Must pay out of pocket…still so much less costly than my pricey insurance. Good luck
Yes those are the amounts. And no, I don’t use my insurance. The prices you are quoted may not be generic apixaban . A real injustice what seniors are being charged for essential drugs!
I am pleased to hear you trusted your instinct and sought medical advice, stay in touch and keep us updated. If you would like a chat, support or information, please do not hesitate to contact the Patient Services Team: heartrhythmalliance.org/afa...
When I am feeling good I never think to check mine either. Since I went into aflutter on 3-22 and have been going between that and afib ever since I try to check it morning and evening and then if I don't feel right. It is helpful to be able to email them to the Dr. My aflutter only shows as tachycardia but I know what it feels like so know when I'm in it. I also can feel when it flips to afib. I went to ER the day it started. Then I was out of town and just not feeling good and HR was in 140s so I went to the ER there and the NP came in and told me my HR was fast but was NSR. I have been dealing with this since I was about 30(am now 59) plus I've been a nurse for 30 years. I told the NP I'm not trying to question you but I bet my life that I am in an atypical flutter. He said he would go look at my ekg again and came back and said you are absolutely right. They gave me 15mg of diltiazem in my IV which took my HR down to 70s-80s. He told me I could increase my diltiazem to 360mg. I had originally been on 180mg then increased a couple weeks before that to 240mg. Also had been in atenolol 25mg twice a day and had been increased to 50mg twice a day. They sent me on my way and withing an hour of course HR back to 120. Now they have put me on immediate release bc the CD was only lasting 8-10 hours. Finally seeing my EP in 6 days ..... this has been a long 2 months. I have been to ER 3 times, 1 hospital admission, and 5 Dr visits. Never been in it this long before. Last time I had it in 2013 I was cardioverted in 48 hours.
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