Extreme Fatigue/Exercise Tolerance

[MeganMN]

I have a question for you all. My situation is a bit different as I do not have Afib, but have been dealing with Paroxysmal Atrial Tachycardia with PACs for two years. I have had increasing amounts of PACs and runs of SVT in the range of 20-35,000 PACs a day (800-2500 per hour)and 800-1500 runs of short burst SVT per day. I am currently on Propranolol ER to slow the rate down, which has helped, but I still get 4-600 PACs an hour and runs of SVT.

I am PROFOUNDLY fatigued and have zero exercise tolerance. I feel short of breath, exhausted, and unable to maintain activities of daily living. I am 49, otherwise healthy, not overweight, and have previously been very active.

Could this just be a response to the constant arrhythmia? I just have no other explanation. It is really one of the most disheartening parts of this whole mess. I just don't feel well. I can't keep up. I'm completely spent.

[Cavalierrubie]

I think you need a review with a cardiologist or EP. I think you probably need more treatment other than just a beta-blocker which is for rate control. There is medication for rhythm control amongst other treatment. Unfortunately, beta-blockers can make you feel tired, as can arrythmia, but you should have a good quality of life and not feel so ill.

[MeganMN in reply to Cavalierrubie]

Thank you! My EP has been following closely and I have an ablation scheduled October 30th but have exhausted all options for medication. The Propranolol is literally just for rate control as rhythm control has failed and I had a severe reaction to calcium channel blockers 😪.

[Cavalierrubie in reply to MeganMN]

Hope you feel better after your ablation. I have problems with most drugs, which makes life difficult. The side effects can be awful for some of us. You are not alone and hope you will get some more helpful replies on here. The journey for some can be rocky, but l am sure you will get there in the end and it sounds as if you are having good care.

[Nursingirl]

My only reply is that you must see an EP and also a cardiologist. You may need an ECHO also. I hope you are seeing an appropriate MD.

[MeganMN in reply to Nursingirl]

thank you! my EP is very skilled, at a big heart center in Minneapolis. I have not been seeing a Cardiologist but have an appt set up with one in November. He is also fantastic, I used to interact with him when I worked in the ICU. Hopefully he can help me get things sorted out.

[Nursingirl]

I am glad for you. I hope you don’t mind me praying for you and you upcoming appointment.

[MeganMN in reply to Nursingirl]

absolutely not! God is good and no matter the outcome, I trust Him implicitly.

[JezzaJezza]

I stress that I have no medical knowledge and I am giving my own experience.

I was diagnosed with SVT and accompanying PACs - as you say scary and also very tiring. My SVT is treated with a modern anti arrhythmia pill called Multaq (Dronedarone) and the PACs are treated with a beta blocker bisoprolol 2.5mg once per day.

The treatment has been extremely effective and I have not had any further SVT and only the very, very occasional PAC - which I can usually associate with a known trigger.

I think you need to talk to your cardiologist.

Best wishes

Jezza

[AKatieD]

Could be but also affected by hormones so may need to get those checked too (eg thyroid, sex hormones).

[Ppiman]

You have an ablation coming up. That should be your saviour. Hold out hope. You haven't got AF, but, like me and others, you have atrial conductivity weaknesses, whether or not that shows as AF seems rather irrelevant to me. It's variable in its impact and you have it badly. A friend has SVT bouts which he can help with various manoeuvres, but he has only a few PACS. These can be very resistant to drug treatment, as you find and be as debilitating as AF - even harder to cope with as they are sudden and irregular in their physical effect.

The ablation could well prove the key.

Steve

[Jalopy]

I have PSVT and was first diagnosed in my early 40s - I’m now 70. The PSVT is well controlled by Flecainide and I also have an implanted loop recorder. Like you, I was very slim and fit and led a very active life but I went down with ME/Chronic Fatigue Syndrome in 2011 (diagnosed in a specialist clinic) and have been very affected since.

My whole body has been affected by this and the cardiologist treating me has queried whether I may have cardiac dysautonomia.

I had my Vit D levels checked and they were low and I now supplement.

My thyroid levels were low and I now take medication.

My B12 levels were low and I have injections every 8 weeks.

I have GERD stomach issues.

I guess I’m trying to say don’t completely focus on your heart issues as maybe other stuff is going on with your body that needs checking out by a physician.

[Jajarunner]

Definitely it would make you feel like that. It's like an engine being over revved all the time.

[Ewloe]

I have bits of a few arrhythmia’s ( PAF, SVT, NSVT), as well as reduced ejection fraction. The fatigue is really frustrating. I can swim a mile in 40 minutes but walking up a small hill and I slow to snails pace. Have you tried something different exercise wise? Slower then gradually increasing it? It’s taken me a long time to build up my swimming. Good luck

[Auriculaire]

At 49 you might well be in perimenopause. If you have other menopausal symptoms you might benefit from HRT.

[doodle68]

Hi Megan, I think any interruption/variation to a normal heartbeat can cause fatigue , it is logical , I had long bouts of PACS when not in P-AF and they caused breathlessness and fatigue.

Good luck with the ablation , mine was delayed by hesitancy and covid measures by which time I had progressed to persistent AF with less chance of success . How I wish I could have had an ablation earlier , even so having one has helped enormously and the PACs disappeared after a few weeks.

[karrog]

Megan, just in case you haven't already, be sure you insist on a complete blood count (CBC). I also have profound fatigue and turned out my hemoglobin level is extremely low, causing low oxygen levels in red blood cells which in turn is responsible for low energy.