I am still waiting for the results of my echocardiogram. Is the reason for AFib always apparent after this as I hope I won’t just be told that I have it and not the reason why, which has been the case so far, after an ECG and a 24 hour ECG ? Thank you.
Echo results: I am still waiting for... - Atrial Fibrillati...
Echo results
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bluepuddy1
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Hi,They don't necessarily know the reason I'm afraid. Sometimes it seems to just happen.
It's a question for your cardiologist to answer as everyone is different.
Thank you llovedogs12.
I suspect for many of us with AF have normal echocardiograms. I do.
Thank you bean counter, to me it’s all a minefield. I’m waiting for the result of my Echo, I don’t think there is much wrong, but it’s a long wait.
Me too, I have lone AF
BobDVolunteer
AF has no reason. It happens. End of.
Telling it how it is. Thank you BobD.
Bob, dare I disagree with you, there is always a reason for everything, they just don't always find out why.
We know what AF is but not why though it is generally agreed that there may well be a genetic function. Of course we also know that some people cause it themsleves by their life style choices. Endurance athletes and fighter pilots both having elevated incidence of getting it as well and teanage binge drinkers and people who are obese. Against that there are always racing snakes with exemplary life styles who have AF so you figure it out.
You mirrored my thoughts. Several causes must exist but can never be found, so Bob’s being the pragmatist as ever.
I suspect for most it’s a combination of genetics and an accumulation of unhealthy lifestyle choices regarding food and physical activity. By the time the AF occurs, undoing those effects is unlikely to be possible.
Steve
Many of us have Lone AF with no apparent cause. In your position a good echo result will be to find nothing wrong and then move on to a treatment plan for your AF.
Have a read of the AF fact file on the following link and anything else that interests you, knowledge of the condition is the key to agreeing a treatment plan with your medical team. heartrhythmalliance.org/afa...
Best wishes
Thank you Buzby for the information. It has all been a bit of a surprise as I didn’t know I had AF, though I did have palpitations and occasional weakness and lightheadedness that I wasn’t really worried about after having been diagnosed with bigeminy some years ago. An irregular heartbeat was found by my podiatrist, a letter was sent to my doctor and AF was identified by an ECG and later by a 24 hour monitor. At the moment I am only on Edoxaban after the beta blocker disagreed with me.
That sounds like you are only being managed by your GP, if so you’ve had more investigations than many get which is good but I would be pushing to see a cardiologist that specialises in arrhythmias called an EP (Electrophysiologist). Some might suggest the private route if that is affordable and agreeable especially if waiting times are unreasonable in your area.
Best wishes
Thank you Buzby.
bluepuddy1
An echo is to determine the effect of afib on your heart plus any other abnormalities.
What was your heart rate range when wearing the holter monitor ? Need to keep it within acceptable range (60-100 bpm) as well as your blood pressure. With afib, spikes in heart rate can occur but should not remain for lengthy period.
Good advice to see a cardiologist or EP. Discuss the need for a beta blocker/calcium channel blocker and an afib therapy program. Also, monitor your heart rate and blood pressure at home.
"Need to keep it within acceptable range (60-100 bpm)"
bluepuddy1
Just to clarify, the bpm referred to by Mav7 relates to resting heart rate. Obviously it is okay to go higher when exercising (but not too high).
You should also discuss rhythm control medication e.g. Flecainide with your medical professional. That's another reason for having an echo - to make sure heart is okay for Flecainide use. Arguably, rhythm control is more important than rate control.
I was told it's the other way around, rate control more important than rhythm control??
Studies appear to have produced mixed results, some favouring rate control, others rhythm control (including ablation).
I think it depends on your circumstances and who you're talking to. I'm not a medical professional but to me it makes sense to try maintain rhythm i.e. not to go into AF. If I don't go into AF then heart rate during AF isn't a problem. Rate control appears to be minimising the impact of AF rather than preventing it.
My medication covers both rate and rhythm control (Metoprolol and Flecainide). Flecainide tries to keep me out of AF but if I have an episode the Metoprolol helps limit my heart rate. I think Metoprolol is also there for protection against some of the potential adverse effects of Flecainide too.
I couldn't take flecainide it gave me a pro arrythmia, however I had an ablation in March which seems to have been successful. I remain on Sotalol at the moment which is an antiarrhythmic and beta blocker
I'm lucky, medication still appears to be working well for me after almost 5 years. Frequency of episodes has reduced from several a year to just 1 so far this year and currently trialling reduction in Flecainide dose.I know I'll probably need an ablation eventually but not keen at this stage, even though earlier is supposedly better.
Pleased to hear yours appears to have been successful.
Thank you, it was the best decision for me as my episodes were very symptomatic and lasted 36 hours, I was having them every 3 months, I just couldn't cope with it. The ablation was no walk in the park, I know it's different for everyone but I found it a bit of a rollercoaster recovery.
Thank you mav7 for information on Echo. I do monitor my heart rate and blood pressure, the blood thinner seems to keep things at a reasonable level. There’s only the occasional spike. I should be seeing or hearing from a cardiologist, probably after the results come in, in about 5-6 weeks. I was getting impatient, but now feel reassured by your and other answers on the forum.
Blood thinners have nothing to do with rate or pressure, they prevent blood clots from forming in your atria.
OK Dennis, I’m learning all the time.
An Echo won’t tell you why you have AF. It will tell you whether your heart is in good shape (pumping well) and whether its structure has been affected. When I found out my own heart was in good shape I was able to stop taking a betablocker altogether, although I only suffer from brief episodes of PAF.
Thank you Drone for your information.
The first time I was diagnosed with AF I had a virus which caused fluid around my heart. But that wasn’t the reason I have AF - it runs in my family so we seem to have a tendency to develop it when the heart is under stress. If the echo showed eg a valve problem that might show why you have developed AF at this time but the purpose of the echo is to show your heart’s structure which will help in a treatment decision. Hopefully your heart’s structure is fine which will increase the number of treatment choices. Hope that helps and the news is good.
Thank you Buffafly.
They will check the internal measurements. Check your Ventricular Function, size of your Rt Atrium,.If this is all within range, which is probably is, If they want to suggest an Ablation in the future these numbers are important.
(I am a NHS Cardiac Physiologist with AF!
I have also qualified as a Cardiac Echocardiographer)
Don't worry.
Hello Whataperformance, I don’t fancy an ablation, but your information is very helpful. Thank you.
Many people have Afib with a heart that is otherwise perfect, but an echo is the best way to discover any oddities, like valve problems or enlarged chambers. If something shows up, the cardiologist can often deal with that, and then there is a possibility Afib symptoms might reduce. However, once you have Afib, it is said it hovers in the background ready to kick in again. I believe only preventing the rogue electrical signals can actually stop Afib - like an ablation - but others on this forum know much more than I do. Look on the echo as a positive anyway, as it will give you an idea of the state of your heart and its ability to cope with the Afib.
Annie
OK Annie. Thank you.
It seemed that the echocardiogram is to check the structure of the heart and I was told that mine was fine by the chap who did it as he was looking. I think that meant that my problem was just the intermittent electrical fault.
Thank you Vonnegut. Glad you are OK.
I certainly wouldn’t say I’m OK! Chronic fatigue does rather restrict me but I have done rather well at all my daily word games and have booked our top up jabs with the surgery and now it’s time for an online quiz with my local ME group.
Sorry about the fatigue Vonnegut, but glad you are at least trying to enjoy life.
I don’t need to “try”! Life continues to be interesting!
Yes, I was going to edit the ‘try’ bit. Obviously you are enjoying life 👍
I understand an echo is a useful check on the physicality of the heart, primarily to determine whether best to change from pills to an ablation or both.
I had one on first AF diagnosis 11 yrs ago, been on Flecainide since and this year following more AF/Flutter my cardiologist referred me to an EP as well as suggesting an echo, which I am having tommorrow and seeing EP later this week.
Reading between the lines if you have any significant AF episodes it is probably best to have an echo every 2-5 years to determine any trend(s).
Thank you secondtry.
The reason for AF is rarely apparent, sadly. Its cause is likely hidden deep within the heart cells and is likely to be long term age- or genetic-related changes in, or degeneration of, the conducting heart cells ("cardiac myocytes").
The scan will show any resultant effects of these changes. For example, if the AF leads to persistent tachycardia (a rapid ventricular response with a heart rate of greater than 100bpm), then this might have caused mild valve weakness and some small reduction in the amount of blood the heart's ventricles pump to the body (i.e. the ventricular "ejection fraction" or [V]EF).
Some AF seems to result from heart surgery, some from high blood pressure, obesity, diabetes, thyroid imbalance and sleep apnoea, but the root cause is usually unknown or guessed at to my knowledge.
Steve
Thank you Steve.
I forgot to add that I had both but they reversed back to normal after my ablation.
Steve
hi puddy, all my echos in the past have shown normal heart structure etc but I still have AFIB.! I was hoping for something to be discovered to answer why I started with AFIB but it didn’t unfortunately for me anyway.!
My last echo showed a tiny amount of enlargement on my atrium with normal volume but this is normal with AFIB And usually nothing to be concerned about my cardiologist tells me. I do hope you get some answers though.? All the best,take care.
Ron
Hello Ron,
The lady who carried out the Echo did say that my heart seemed to be of a normal size so your answer and others received have made me think that there is little cause for worry. I’m very grateful for your kind answer.
I had a normal echo last week. She could see ectopics firing in the top of the atria but otherwise valves and structures all fine. I'd say stress has a lot to answer for to be honest.
Thank you MaryCa, glad you had a normal Echo. You are right about the stress it seems to cause so many things.
Echo's are used to show any heart irregularities that may affect treatment of afib. It is possible that a heart issue could trigger afib, but it wont be conclusive on an echo. An EP doing a Electrophysiology Study is a more conclusive means to that end.
Thank you Dennis.
My echo is always normal - but why do you have to wait? I live in South Africa and mine is done during my consultation with the Cardio and it goes straight from the equipment that his assistant uses to do the echo to his computer on his desk and he tells me about it there and then at the consultation after I have got dressed 😀
Hello pusillanimous,
We have an overburdened, free, National Health system, dealing with numerous patients and often suffering with staff shortages. Private care would probably mirror your experience and avoid a lot of anxiety, but, hopefully, if one’s heart problems were more serious, there would be a more rapid response from the National Health cardiologist.
True, I recently had an echocardiogram and had notice of an appointment for a phone consultation within a few days and have also had a letter outlining the problem found.
Well done Buffafly.
I think here in the UK it's very different. Generally only see a specialist cardiology nurse and then at a later stage the consultant sees it when you're not there and advises via a letter.
Hello Bluepuddy1, welcome to the 'club'.
In the absence of any structural heart abnormalities, haemodynamic problems, clinical diagnosis of thyroid or kidney issues, the likelihood is that you will join the 'lone' AF gang. The doctor may call it 'idiopathic', which is Ancient Greek for 'search us'. However, there is a growing backlash against this label on the basis that of course there is always a cause.
That's right, but not necessarily in the fatalistic way medics like to think.
It sounds like you are stuck in AF, which is to say that you have not been especially aware of it in the past, so you are not very symptomatic, and it will have probably become 'permanent' as opposed to paroxysmal.
However, do not get side-tracked into debates about the relative merits of controlling rate versus rhythm. Most everybody as otherwise fit as you wants and deserves to get back into NSR. I was the same, and beta blockers made me feel 90 (I was 50).
So, do not allow the possibility of getting you back into rhythm to be lightly discounted, or be fobbed off with notions you have been out of rhythm too long.
As others have said, you do need expert counsel from an EP, privately if need be. And the first order of business should be discussion of a shot at chemical and, if that does not work, electro cardioversion to see if NSR can be sustained, albeit with some ongoing drug support.
Be aware however that to a child with a hammer everything is a nail, and many EPs make their living by doing ECVs, ablations, PVIs, hybrid procedures etc..
I would counsel not getting drawn into heavy duty medical procedures just because you have a condition that is on the medic's radar. The causes and the remedies need not be proportional to the apparent seriousness of their consequences.
I would take this as a wake up call. And the solution is not just to knock off the alarm but to get in the driving seat in terms of your healthcare.
I would not allow yourself just to be 'put on maintenance' by the NHS either- anti-coagulation, something to keep your rate down (beta blocker), 'no one dies of AF' etc.. It is life-limiting if this is just an indefinite holding-pattern with no curiosity about causation.
There is something of an epidemic of conditions like this at a certain age and the point to grasp is that AF can be induced in anyone - EPs do it all the time in surgery to isolate the problem.
It is a question about lifestyle, diet, weight, longstanding habits, psychology, stress, and genes lowering our threshold, and a bunch of sub-clinical conditions that taken together matter but your GP will probably regard as too hard/inconsequential and ignore, from Gilbert's syndrome to latent hypothyroidism.
You have been on PPIs which are prescribed a little too freely for every digestive problem, irrespective that most common among them is low stomach acid, not high stomach acid at all. And if your acid is low you will not get the vitamins you need even on a decent diet.
The B complex, particularly B12 and Folate will be crucial here. Have a complete thyroid function panel done, which will include these things and identify whether you have a latent T3 conversion problem too, it is very informative and costs about £80. See advice on our sister site about timing, discounts etc.. UK GPs can be notoriously obdurate about thyroid problems.
Weight loss can be instrumental to recovery (I lost 16kg over time and had never considered myself overweight for a 6ft guy). However, diet (e.g. cutting out the carbs) and supplementation guided by evidence is vital.
It took me years to get a purely coincidental B12 test, whose result led my GP to have a colleague call me to see if I was compos mentis! (B12 deficiency can cause dementia). And I had to find out myself that I have a common gene defect that affects T3 - imperative to mitochondrial function, and these little guys literally make us go and are vital in heart tissue.
Apixaban caused me severe UTIs a know side-effect and contraindication. In the absence of adequate stomach acid anticoagulants can be hard to digest, and cause problems. I fought to get dabigatran (not too hard really because it is cheap, twice daily, and like a horse pill!) as there is evidence it remodels the heart substrate that supports AF and also reduces inflammation, which is often central to AF - not a few people point to vaccination as being a spur to inflammation and possibly autoimmune thyroid conditions. However, NEVER take dabigatran on an empty stomach, acid is essential to assimilate it, and much the same probably applies to others of the type.
Some stuff to think about anyway. I hope not TMI. I was diagnosed in 2009 much like you, purely incidentally, during another routine procedure. And, like many of us, have been down the whole route, only to find that the solution was probably in my own hands all along, despite the pessimism and portentous admonitions.
I hope that they do not find a 'smoking gun' for you (no structural anomaly). However, in a medical culture of 'Good news, Madam, it's serious', that's just the beginning.
Nevertheless, trust me, it can be a valuable, learning and ultimately beneficial journey if you do not surrender your own agency.
Pretty normal I'm afraid. This too is what happened to me.
Glad it wasn’t serious julielj
Hello TeaFree,
Thank you for this, after switching from one blood thinner to another, because of side effects, your explanation is useful. After having given doctors a wide berth I only started taking tablets when I had Polymyalgia, which I have been reducing as much as possible. Now it seems that tablets are the order of the day with AF. Beta blockers upset my stomach, also Lansoprazole, Apixaban is not much better so I am switching to Edoxaban. I have felt whilst waiting for results that I am not quite in control of things, but I am determined to make intelligent choices and not accept things that could undermine me medically.
Your views have been extremely helpful, as AF seems to be a bit of a minefield.
The echo just gives information about how well the heart is pumping, and about how the valves are working, but sadly not the reason that electrical signals are misfiring.
Are you in persistent AF (all the time), or paroxysmal (comes and goes)? I have twice been in persistent AF, and each time had a cardioversion. The first kept me in normal rhythm for 3 years 8 months, the second has lasted 6 months so far. I do take a beta blocker and an anti-coagulant, but feel better in normal rhythm.
I've also read about dietary factors that can be triggers, plus noticing a few foods that triggered ectopics, and adjusted what I eat. last time, dehydration might have been one factor, so I try to make sure I always drink enough.
Best wishes for your results.
I don’t know which it is yet, doubtless the cardiologist will let me know. I do have lightheadedness some mornings and feel unwell, prompted maybe by not enough sleep and/or dehydration prompting an AF episode. It is occasional.
Thank you Belle.
Good that it's occasional. A cardioversion wouldn't help for you then as it only works if you're in AF all the time. I hope you find some solutions for yours.
Thank you Belle.
Hi
Yes, indeed.
AND
It will tell you how your heart is and defects.
This assists your heart specialist what to do next if anything.
You know when you think you have heart troubles.
Take Care.,
Cherio JOY. 75. (NZ)
I got a simplified result within 10 days. If not ring up your DRs.
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