I was diagnosed with Afib-RVR. I am from the US, and I was in India, but I fell sick on my way back. I had a fever of 103.5F on the flight and after I reached home. I probably had a fever for 3-4 days. The day when my fever went down, I started feeling a racing heart and breathlessness. I went to my primary doctor who did an EKG, who also tested me for Flu and Covid. He said I had influenza A and sent me to the ER. They admitted me to the hospital and gave me Diltiazem on discharge. I was in and out of Afib and the cardiologist put me on Flecinaide a week and a half later 50 mg twice a day. I am on Eliquis as welll. Since then my Afib seems to be under control, but at times my HR goes up suddenly. Not sure if that is because of Afib. I am 54 M. The diagnosis and RVR have made me depressed. I am in constant fear that I will go into Afib. I do not want to go to the ER as it is expensive. I greatly appreciate it if anyone could let me know if I can wait out the Afib episode with HR as high as 200 till I can contact the cardiologist, especially on a weekend. Also why the sudden rise in HR? Should I ask my doctor to prescribe me more Diltiazem or Metoprolol? Thank you. This forum has been a great support to me since my diagnosis.
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Hi, it’s difficult to answer without more information but I’ll just give some general advice.
If your HR was constantly at 200 bpm you would probably feel you really need to be in A&E with symptoms such as dizziness, sickness, breathlessness, possibly chest pain. But if 200bpm is a random spike for a few seconds or minutes you should be ok resting at home. The average HR is the important number. It is really up to your doctor to decide on your meds dose as if you take a high dose to cover a few episodes of AF you are being over medicated the rest of the time.
Yes, there are several strategies to keep people out of the ER during an afib episode with RVR. The first is a rate control strategy where you take a drug like diltiazem and/or metoprolol to lower your rate to safe levels while waiting to convert. The second is a rhythm strategy, where you take a drug like Flecainide at the start of an episode to convert. Soeak to your doctor, preferably an electrophysiologist.
I'm trying to work out your description of heart rate going up suddenly. If your pulse is all over the place known as irregularly irregular, that is most likely AF. If your pulse is suddenly fast but regular, that is tachycardia from some cause or other .This not a diagnosis just a fact. I get very short episodes of one, the other or both, but only a few minutes long usually. The 'regular' fast heart rate drops by half as suddenly as it came from 120 ish to around 60.
AF I can't really count if above 120 but it is all over the place and reverts to regular pulse of 80 or so then slowly back to my normal.
I take flecainide 100mg twice a day and have done for years. It was once reduced to 50 because of the runs of regular tachy by the GP and 3 years later increased by consultant for the same reason.! Still here. It is unsettling I know. I'm sure you'll have tried various strategies such as long slowbreaths, face and wrists splashed with cold water, drinking iced water.
Hello, It is suddenly fast but regular according to iWatch. It drops again after a few minutes and sometimes within a minute or so. Is it due to Flecinaide? or is it due to Afib?
I can't answer that, it's a doctor required question! As you've only recently started Flecainide, I would ring your cardiologist's secretary and report it. The cardiologists I have seen did not seem unduly concerned in MY case but we are all different.
My son in law is South Asian and I know heart issues are more common for you, so you are right to be concerned HOWEVER, deal only in facts not in what you imagination dreams up, this will reduce your fears.
I would seek more advice/a second opinion from the medics on your pills.
Scary as AF is at first, aim to balance medical advice with lifestyle changes. Personally as much as I would grab the chance to be rid of AF after 11 yrs, I know that would have consequences as I sink back into poorer lifestyle choices, decreased religious beliefs and less focus on today to improve the lives of others through a social enterprise I am involved with.
I’m so sorry to hear you getting hit with a fib in such an awful way. Here’s the bad news. A fib is not curable so you’re gonna have to get out of your head about it once you are under good care with your doctor. he will do the prescribing that’s his job he already has you started it’s hit or miss in the beginning at the pain in the neck. We are also different. What works for you and how much might not work for me. so take a deep breath because you are going to be on a new journey. No doubt the flu did a number on you and complicated everything as well. I would say most of us get depressed and upset. My first event. I woke up on the floor didn’t remember anything that happened. You don’t have to run to the ER. you do need to see your doctor ASAP because a high heart rate does damage but unless you were blacking out, I will tell you right now. The ER will keep you and make you stable and comfortable and that’s it. They are not gonna be able to set up your long-term that’s your Cardiologist and probably, your EP who you doubt we meet very soon. I’ve met my cardiologist on a Monday and by the end of the week I had my EP and was scheduled to my first ablation this was just a couple of years ago already they are doing things differently. FYI, so I’m not going to tell you this is how it will go but its possible. my first visit I was put on an antique coagulant and I forget which one now I am now on metoprolol but I wasn’t back then. just my last visit I had an increase and now I have a pacemaker so they are always trying to make you feel the best you can and that may increase your meds please do not stop here anticoagulant under any circumstances unless the doctor says so how often does it go over 100? Is it when you are anxious your own anxiety is not helping with it. when you talk about a high heart rate, it depends how you mean it right now you’re gonna be looking at every little thing and feeling every little thing that’s why I say get out of your head. If you have devices, don’t keep taking your numbers again. It will make you crazy, it’s one of the first things. My doctor made me stop doing.
You definitely need another opinion, and as I said, most likely an EP think of him as the electrician of your Heart the Cardiologist handles the rest of it such as your arteries, etc. usually they work together. It’s great if you have two doctors that work like a team even in separate offices. I had it in Florida and I have it now and Texas.
you have so many people on here that will help you get through this. It’s not a one time thing usually if you have a fib or flutter, you really need to find out exactly what you’ve been dealing with.
wait until you see how many new friends you have here because we are all in the same boat. None of us like it. We all need to learn to cope and you are going to find you have a lot of us right here with you. Best of luck.
PS. you know what the ER. now if you have heavy chest pain or blackout, etc., what I found was most of mine was almost like the signs of a heart attack, but it was not a heart attack. I went to my regular GP. He didn’t send me to the hospital, he took one step at a time. I had. tachycardia from day one for me it was constant. I could not stand up without tears coming because of the chest pain among other things. I am stubborn. I’m not going to sit at the ER to be thrown on a bed and have the money meter start. I asked my EP recently and even now what I asked him was would go into the ER to and he said no. That being said never ignore signs of a heart attack. They are two separate things I have a pacemaker I can still have a heart attack. We all can. I just saw another post from you and I see it settled down. Of course it is scary. My anxiety can make it so much worse I had anxiety prior and I do have panic attacks. Everything is not necessarily the heart. Pay attention to your doctor remember, he is the doctor not you. Remember it’s going to take time to feel better. If he talks ablation, which is very common here in the US don’t be afraid it’s relatively painless. You go home the same day usually. You may get some aching or a headache usually from your anesthesia FYI I have wonderful luck starting a fib right in the middle of Covid the first time around I did not have it, but you can imagine what the hospital was like.
you don’t say where you are if you’re anywhere near me in Texas, give me a shout. I have the best doctors you could ask for my EP is in Lufkin. He is young humble think outside the box. I can’t say enough about him because he saved my life. I had a lot of complications, remember knowledge is power
get rid of the watch. I had an oximeter. if you keep taking your rate you are going to find it may keep increasing and you are also going to find you you are going to make yourself and your doctor go bananas. Perfectly healthy and athlete has his heart rate go up. No you don’t continue with it. I had it for quite a while and ended up with heart failure. that was my fault for waiting after experiencing a bad doctor Who is supposed to be a rockstar. The most important thing you can do right now is go to a good cardiologist because you will need a referral most likely for an EP think of it is the fact that the Cardiologist is the screener and get you prepared the EP is the top of the food chain with very particular skills. It’s amazing everything from IT plus
here in England for a high heart rate and blood pressure the first go to is bisoprolol which is a rate control drug and possibly flecainide which is a rhythm control drug. Also to keep you safe from strokes/blood clots an anticoagulant.
If your bouts of fast heart rate are very short it could be tachycardia, although if you have been diagnosed with Afib, but only your cardiologist or an EP could decide on this
If my heart rate was 200 (it did used to go to 240+ sometimes and was an ambulance blue light journey to hospital - 11 times once before a couple of Xmas ago) I would go to your hospital or call an ambulance. I do appreciate your reluctance with the cost in America but you need to be safe
All the best snd try not to worry as that can raise your blood pressure and heart rate, although I know not easy,
afib equals anxiety, I’m going on two years since being diagnosed at age seventy. Two cardio versions and an ablation later I’m still on meds but a lot more confident than I was when the journey began. I believe you’ll get your swagger back soon I hope.
I was on diltiazem for 4 days and got so dizzy , then I took metoprolol for about three years and I had them take me off because that made me dizzy somewhat so now I am on Nebivolol 5mg and so much better I feel!
I can understand your worry. I had that for 1 year 5 mths before Metoprolol was stopped and changed to Bisoprolol but both BBs did not control my Heart Rate.
I was so fatigue and breathless on Metoprolol. The hospital heart cardiologist carried out a 24hr heart monitor. I couldn't exert myself. 186avg bpm on it Day but Night my normal is low at 47avge bpm. AND pauses during the night.
Enter private H/Specialist and he introduced Diltiazem. 180mg took me down to 51 from the Bisoprolol 156. I was concerned and some light headedness so the NZ Heart Foundation nurse whom had worked for the private specialist rang him and settled for 120mg CD early morning. Now 2.1/2 years later 60s Day, no breathless or pauses (like Bisoprolol ) and 47avg bpm Night.
I take the Bisoprolol 2.5mg because that controls my Systollic and to a lesser degree Diastolic BP.
The Diltiazem should cover 24 hrs but it does not and so allows the low Night H/Rate to stay stable at 47bpm avg.
RVR means ?
If it is Right Venticle Regurgitation I have that also caused I think by my severe dilated Left Atrium. Due to being left at high Heart Rate too long.
I would concentrate on the High Heart Rate and as Diltiazem control H/R . You may need 120mg twice a day. As I illustrated I d not need a further dose at night. (360 mg is the maximum dose).
Is it the Diltiazem CD you are on, also what make the inferior was ACCORD which we had to have as an alternative because of manufacturing problems over COVID.
Flec..... is only a n anti-rhythmic drug which I cannot have because of an abnormal heart - the atrium dilation. Haven't you got that as well making the RVR if my abbreviation transfer meaning is correct. Flec .. quite risky and doesn't suit everyone can make you worse as it has side effects.
Actually Diltiazem acts as a SAFE anti-arrthymic med. I continue from my diagnosis STROKE, Rapid & Persistent AF and 4 days later they added Papillary Thyroid Cancer.
The Stroke was embolic. A rogue clot due to the AF - I was not on any meds apart from B12 sublingual 1000ug nugget Gold Top SOLGAR.
I would be surprised if AM and PM Diltiazem say 120mg CD is enough unless you also have BP problems.
I was told to be strict about separating BB with CCB. Never take them together.
Taking Diltiazem twice daily with no BB or Flec... I reckon might solve your uncontrolled h/rate. AF is causing your H/Rate to be high and I feel your dose once a day is not covering you fully.
As your Dr is aware that Diltiazem has been prescribed changing the dose by your Dr shouldn't be a problem. My Dr did but I guess that was lowering it.
So do you any issues around your BP Systolic and Diastolic Rates? Do you have a BP Monitor at Home. Omicron or a love my Microlife which has different sizes of cuff.
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