Advice Please

[JMF1]

Please accept apologies if this is not the correct support group - just concerned as having Atrial Fibrillation from first thing in morning until I go to sleep. Not sure if this is related but pulse low at 40 and stays at that with occasional increase to 51. Have thyroid problems and advised to reduce tablet from 100 to 75, told to stop Bisinoprol but increase Losartan to 100 . Get frightened when the palpitations start. Any help please. Thank you.

[BobD Volunteer]

Your heart rate is very low as normal is between 60 and 100. I take it your AF has been picked up by ECG and confirmed lack of P wave?

[JMF1 in reply to BobD]

Yes that is correct just concerned about pulse rate

[Jalia]

With a pulse rate that low you should bring this to the attention of your GP

[CDreamer]

I think I would also be concerned with that rate but it also depends on how sympathetic you are as for some very fit people that may be ok. Have you seen a cardiologist? If not I would suggest you insist on a referral asap.

[Blearyeyed]

Are you still on the books of any Specialist? If possible you would be better contacting the Cardiologist or EP whom diagnosed you and prescribed your current meds .

You can do this by getting the direct number to their Secretary ( you can ask for this by ringing the hospital reception ) then call them explain the circumstances, particularly the low pulse and ask the Secretary if they can get the Specialist to ring you back with some advice about your doses, or if they can get the doctor to give them the information to call you back with asap.

If you are in AF it could be caused by the Bradycardia ( low heart rate) , you may need to go in to have an ECG and get some treatment to help get it back under control.

If the AF is pretty constant and you are scared but can't get hold of a Specialist it might be a good idea to go to the hospital and get it sorted out by going through the AandE or Out of Hours route.

Hope things settle soon , you are in the right place , so if you feel you want to post to get some friendly support while you are going through this please do so whenever you need to. Take care , Bee

[opal11uk]

If it was me, I would seek referral to a cardiologist, perhaps have a halter for 24 hours so they can get a snapshot of exactly what your heart is up to and take it from there. Not something I would leave. Good luck x

[Omniscient1]

....and did you know there is a thyroid forum on here too, worth asking them. I presume you mean your Levo has been reduced? Must be a reason why, I presume you'll feel a bit trashy after the change in dose anyway?I'm not clear on the connection (any connection) between AF and thyroid problems as the latter is as you'll know an endocrine problem.

[PoorlyWifeHeart in reply to Omniscient1]

My wife currently has thyrotoxicosis - thyroid very over active - and one symptom of that is that it causes her (previously) paroxysmal AF to become more persistent. Until changing drugs a few days ago she was only getting a handful of hours (if that) each day in NSR

[Omniscient1 in reply to PoorlyWifeHeart]

Thank you for explaining, and all the best to your wife.

[JOY2THEWORLD49 in reply to Omniscient1]

Hi

The thyroid site I dismissed as no one were getting support and when I tried I found I couldn't.

Might because it's called Thyroid UK.

Because there is a real connection between AF and Thyroid Problems. It can be cancer or can be thyroid not working converting in the T3 and T4 scenario.

Its actually easy to help those hypo with lev/synthroid but hyper apart from keeoing to a low iodine diet often some folks need RAI radio active iodine treatment.

Its easy with me that because no thyroid I find it easy to control the TSH. As I had low risk cancer the indication by top surgeon Mr Gary Clayman (I read his book) the ATLAS HEAD AND NECK. So my surgeon reads his direction and I put him up to read these directions.

So we settled on 1.5-2.5 TSH.

Don't worry about the T4 whilst you are levelling your TSH.

I've been at it for 4 years 4 months.

I can get TSH checked at any time. Keep soy. tofu, greens, no seaweed (intense iodine) down and away from taking your thyroxine.

cheri JOY. 75. (NZ)

[Tapanac in reply to Omniscient1]

Jean knows as she had problems with thyroid

[JOY2THEWORLD49]

Hi

I'm AF as well as a thyroidectomy and 12 lymphs removed with 2 infected with papillary cancer.

So stroke was caused by AF and Af caused because thyroid was a problem.

The normal thyroid TSH is .6-4.2

Below .5 is getting hyper.

above 4.2 is hypo.

AF is caused when your thyroid is in trouble.

Thyroxin the synthetic replacement hormones which everyone needs for functioning. have early AM and wait 1 hr before breakfast. No milk / soy/ iron for 4 hours.

What is your TSH, T3 and T4?

T3 is 3.9-4.2.

T4 total is 8? - 22

To keep your TSH normal you may need to decrease your Lev... or Synthroid it to raise or increase it to decrease your TSH.

Perhaps you can tell us why you are on Lev../Synthroid.

Your H/rate is low day. mine is controlled to 60s. Night is 47avg.

cheri JOY. 75. (NZ)

[Ppiman]

I was told that a low pulse is okay if there are no symptoms of concern from it. I have been having many days as you describe recently, which are worse if they follow a poor night's sleep. Today will be one of those. With me it is continuous palpitations caused by ectopic ("missed") beats rather than AF (which comes and goes at will, maybe once a fortnight).

Losartan is said to protect the heart and kidneys (I take 100mg each day). Bisoprolol reduces heart rate, as well as helping to stop it racing.

Thyroid problems associated with AF seem to be mentioned quite often on this forum.

Steve

[JOY2THEWORLD49]

Hi again

You are taking LORSARTIN (An Ace) and Bisoprolol (BB).

Both treat hypertension.

Lorsartin did not help and I had lots of protein in my urine.

Bisoprolol controls my BP but not my pulse rate.

A suggestion would be to have a 24hr Heart monitor to prove what your meds the above only are treating your heart.

Levo .. / Synthroid both thyroxine would not cause low pulse. If you had rapid which I had it affected my heart by sweating profusely and fatigued.

But introduction of CCB Diltiazem brought down h/rate to 60s Day and my low 47avg Night stays.

I found Day 51 was to low so 180mg was reduced to 120mg.

I would think that one either Ace or BB be monitored for you.

Check with your cardiologist.

The problem is that Cardiologist for heart

and a Endocrinologist for thyroid although my general surgeon get together and work things out. I declined 2 thigs the Endocrinologist tried to push. She was disregarding my age and cardiac diagnosis.

I feel if you get your thyroid normal first, then a 24hr H.Monitor will give you a story about your meds.

I only tae 2.5 Bisoprolol for BP. No Ace blockers.

Take care. Yes we have 2 conditions to deal with. Both are as important.

cheri JOY

[SamAdmin Administrator Arrhythmia Alliance AF Association]

Good morning JMF1

Thank you for you post on the Atrial Fibrillation Support forum.

Have you spoken with a health care provider about your AF? If is carries on being low please contact your Doctor.

The normal heart rate for your heart beat is 60-100 but other peoples normal can be lower than 60 and just above 100.

Kind regards

SamAdmin

[Tapanac]

my friend who actually doesn’t have a heart problem had her thyroid tablets lowered as they gave her palpitations.

[Mugsy15]

How are you monitoring your heart rate? I ask because the majority of home devices are designed to detect the rate of normal sinus rhythm. They require a run of regular beats for their algorithm to produce an accurate figure. AF is erratic so such devices simply cannot do their job.

I note, however, that you quote a single figure of 40, which may mean your device is equipped to cope. We often see posts on this forum from people alarmed by the figures they see on their devices, which typically jump around from very low to very high.

[Drone01]

Bisoprolol even as low as 1.25mg took my pulse down from 60 to the low 40s and I stopped it because I really didn’t need rate control for my paroxysmal AF. Took an ACE inhibitor (Lisinopril) for blood pressure instead. Stopping Bisoprolol should see your pulse return to normal levels. If it’s still jumping around you could perhaps ask whether you should try a rhythm control medication (though they too have their problems).

[Auriculaire]

Have you had thyroid blood tests to see if you are actually overmedicated? Being hyperthyroid or overmedicated is unlikely to result in such a low heart rate - the opposite actually as the thyroid gland controls the metabolism. Dropping your levo could result in an even lower heartrate. You should have inout from an endocrinologist as well as a cardiologist.