Hi. I'm Amelia. New here. Age 63. Paroxysmal AFib since at least 2015. Dx in 2018. Rx Metoprolol.
Question: is there any way of measuring the force of your irregular heartbeats?
Just wondering if that could explain the difference between people who don't feel their Afib and people that feel all of it.
I feel all of mine. It shakes my esophagus and makes me cough. It shakes my chest so hard I can see my clothing shake. It makes it difficult to concentrate on anything. Mild pain down my left arm. Mild headache. But I only have episodes 2 - 3 times per week, (3 - 4 hours each) if I'm careful what and how much I eat. Nonetheless, I feel like I'm dealing with it every single day because every day it threatens to happen.
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Hi Amelia, Sorry you're going through that each time you have an episode.
I don't have a direct answer to your question as we all feel our heart differently, both in and out of atrial fibrillation.
Have your doctor's ever discussed a daily anti-arrhythmic with you like Flecainide? Three to four afib episodes a week is a lot and especially when they are as symptomatic as you describe. A daily anti-arrhythmic may prevent them from happening in the first place.
Another option is catheter ablation, especially if you notice that the frequency of your episodes has been increasing over the past several years. The 60's can be the perfect time for these types of procedures as you're still relatively young and therefore should be able to tolerate them well.
Thank you. Taking an anti-arrhythmic has not been mentioned to me. A possible ablation has. The idea of an ablation is frightening to me, but I am cautiously considering it. Maybe I will ask about an anti-arrhythmic before deciding on an ablation. Thank you.
You might ask your doctor -- not a gp and preferably an ep (electrophysiologist) -- about daily Flecainide which is an old standard anti-arrhythmic. You may have to qualify with a recent stress test and echo and then it would be taken daily alongside your Metoprolol.
As far as ablations, they have come a long way and now the newer Pulse Field Ablation (PFA) is being offered in many US centers. Certainly no rush and anti-arrythmic's reasonably could be tried first, but if your afib frequency is increasing, chances are that it will continue to do so. I had my first ablation in my 70's, but wish I had it in my 60's when my body was stronger and able to recuperate better.
Point being don't wait too long for an ablation if you think you might need it. And if/when you get to that point, best results are from the top ten high volume cardiac hospitals, a list you can find at US News and World Reports. You want an ep who has done thousands of ablations, not hundreds.
Hi Amelia, that’s a very interesting question and I’ve just tried and failed to find the answer. There is blood pressure of course, and the effect of adrenaline and the drug digoxin which make your heart beat more powerfully. I don’t have the effect you describe unless I have clusters of ectopics so I do wonder whether you are having ectopics or a mixture of ectopics and AF. Also the mention of eating affecting your episodes makes me wonder whether you have a digestive issue such as bloating or a hiatus hernia.
I agree that your have too much to put up with. We recently had a discussion on the subject of how much ‘acceptance’ is too much and you are way up the ‘too much’ scale so you need to make a fuss. Best wishes ❤️🩹
Thank you for your input Buffafly. I have been wondering whether or not I have a hiatal hernia. I plan to get that checked out. I didn't know about ectopic beats. I'll have to read up on that. Thank you.
Good morning Amelia, In the final end of a longish journey I ended up having a Pacemaker and my AV node ablated, This was in 2022, best decision as I am now back to as normal as can be, including golf 3 x per week. The only tablet I take now is Apixaban, a blood thinner.
Once you decide that a pacemaker will be the only thing keeping you stable, your quality of life becomes paramount and does improve.
In fact I am so confident I have recently had an operation on my lower back to decompress my nerves and to fuse L4, L5 and S1 discs. Had problems for years and as I progress wish I had it a long time ago.
I am very interested in you're being able to. play golf. I had acute percarditis three months ago and whilst recovering in hospital, was diagnosed with AF, maybe caused by pericarditis, maybe pre existing no one seems to know, but couldn't feel it before and still can't.I was put on prolol and Pradaxa - no chance of playing golf though, general weakness, breathlessness, lethargy, bloating, swollen ankles - could be side effects of the drugs, could be after effects of the pericarditis - they are all very similar.
I did a par 3 very flat 9 hole course a couple of weeks ago and next day felt very poorly - won't be trying that again for a bit. I am 76, so a couple of years younger than you - and was, I thought quite fit. And I had my best round of golf for several years the afternoon before the trip to hospital in the evening. Really unfair!
So I suppose my question is, if it's the side effects of the AF drugs then how long did these last with you - if it's the percarditis then it is what it is I suppose, the literature says recovery is three weeks to three months, and it's coming up three months
Good morning ParrotY, I slipped a disc when I was 23, from then on my whole spine deteoriated. Decided I could not go on, my golf was awful and my handicap was for me embarising. When on 'drugs' for AF i definately felt shattered and no energy. Am now only on a blood thinner and feel back to normal, plus now of course even better after having nerves decompressed and discs fused
Off topic question but I have to ask. YOu said "In fact I am so confident I have recently had an operation on my lower back to decompress my nerves and to fuse L4, L5 and S1 discs. Had problems for years and as I progress wish I had it a long time ago. " Can I ask what kind of consultant you saw? I have 5 compressed discs, spondilo lysthesis and spinal stenosis getting worse and worse for 30 years. Now at top dose of painkillers ( oxycodone) and no one will touch me. I've seen orthopaedics and neurosurgery. Not keen on such a nasty operation but I can't go on like this. Not asking for surgeon names, just type. GP Is no help and just suggests pain clinic who are useless.
Good morning Qualipop, I have had disc issues since the age of 23 when I slipped a disc. Since then, as with age, my lower back became more painful, and after consultation with a Consultant who specialised with the spine, I was sent to a 'Pain Clinic'. Was advised to take Tramadol 2 x times per day, 100mg each.
I decided to try once more as my golf was awful as my physical state continued to become worse. I had seen this Consultant agout 5 years ago and decided to leave the op as the outcome could have been worse than my current state, he did say 'You will be back'.
True enough, and this time after viewing the MRI scan I was amazed to see how compressed my nerves were. So went ahead with the procedure, after 6 weeks yesterday since the procedure, I feel better than I have for years, no pain or ache. Will still need to be careful for a further period of time before I will be confident enough to go back to golf.
The Consultant was Ian Harding who I saw at The Spire, Bristol, and I am wishing I had it done years ago, but of course technology moves on.
Many thanks. What was his actual title? Spinal specialist? Neurologist, neuro surgeon or something else? I've watched spinal ops on T V and they scared the life out of me. SO risky. I'm glad yours has gone well.
Metoprolol is my banned med which was for 2nd time prescribed after Stroke with rapid and persistent AF. The Thyroid cancer caused it, newly diagnosed on day 4 whilst examining carotid arteries - shadow on my thyroid!
First Metoprolol is not good for AFers or Asthmatics. Ir did nothing for my rapid heart rate @ 186 Day avg NO EXERTION I couldn't. I had declined it this 2nd time. 1 year 3 months and down to 1 x 23.75mg on 24hr Heart Monitor proved no control of Day Heart Rate, Hypertension and my normal 47bpm Night had pauses.
Reason giving it to me was EVERYONE gets Metoprolol at stroke level. By the way my carotid arteries were CLEAR. So I was prescribed 110mg PRADAXA x twice day. 70 years then. I chose it from the list. I felt twice a day has less risk if it needs to be ceased. (ACCIDENT)
Your symptoms are such that careful examine of your med Metoprolol needs to be reduced or changed. What is not being controlled - high heart rate, or low/ arrhymnia/BP high or low.
You haven't conveyed these vital conditions.
Do you have an inkling what causes your AF episodes.
Luckily I get no symptoms - no pain, flutters. palpatations etc. My symptoms uncontrolled were sweating uncontrollable and no energy/for exertion. If I exerted I had to stop, lay down and generally slept.
I hope that you get sorted. A caring heart specialist with an interest to help you in mind is the best.
I have CCB Diltiazem 120mg AM for control heart rate.
and Bisoprolol 2.5mg PM for control BP.
Your GP won't change you so a Heart Specialist will order an ECHO, ECG and 24-hr heart monitor which will assess what your meds are doing. Your h/rate via Dr physical/stethoscope during AF episode.
AFs are recommended to have smaller more frequent meals, no alcohol etc. Blood tests for levels heart functioning/ minerals potassium/magnesium/ B12 and Folate / Iron and Vit D. a must/. Lipids etc.
Those are like mine - and more often from the long runs of ectopic palpitations than AF. It is very wearing and hard on the mind. I had it all yesterday afternoon during a theatre visit, and into the evening. Luckily it tends to stop when I lie down in bed.
Symptoms from AF can be from its effects on the ventricular output, blood pressure and supply of blood to the brain, which varies individually, I gather. In the unusual event where there is too much of a reduction, then symptoms will arise, occasionally requiring urgent treatment.
Also, however, there can be physical differences between sufferers, which I think are relevant. In some people, for example, the oesophagus presses tightly against the atrium and this is likely to have nerve endings in it that can be directly felt (which the heart itself does not posses, interestingly). Also, in some, the stomach can press high against the diaphragm and, similarly, directly press against the apex (bottom) of the heart, causing PACs to form even, and potentially AF and, again, this could cause feelings indirectly from sensory nerves in that area.
Have you not been offered something like Flecainide to take when an episode occurs.? That’s what I was prescribed by an EP I saw privately after the lowest dose of Bisoprolol was too much for me to take daily as it brought my heart rate down too low!! We all know here that we are all different and must find what works for us as individuals. Now that I take the Flecainide twice daily, I haven’t had an episode for well over a year now. Good luck finding what works for you!
I can hardly believe you are only taking metoprolol. I have highly symptomatic AF like you and would be going crazy at that level! I'm guessing you are not under the care of a cardiologist or an electrophysiologist, and given how expensive health care is in the US, maybe only occasionally under the care of a general practitioner? Right now I'm taking flecainide pill-in-the-pocket (PIP) but will probably be back on flecainide full-time before long, and my AFIB is nowhere near as frequent as yours (although they used to last longer before PIP). Sotalol might also be a possibility. You could purchase a Kardia device to document your episodes before you see your doctor and maybe (I don't know) avoid the cost of some of the tests they usually do to confirm AF.
no-one here (or anywhere) has really answered your main question, which was about measuring the force of heartbeats -- very interesting -- ppiman's comments are very relevant as to why they are felt so very strongly by some and hardly at all by others (such as me - AF for many years - only feel the beats if all is v quiet and still - then I just note how v irregular my pulse has become, and maybe just a bit stronger than normal definitely no ER or A&E) -- I do wonder whether in some people other muscles might start twitching in sympathy -- eg diaphragm, chest, pectorals or neck??
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