feeling faint when going back into NSR

[Sandyc2705]

I have had AF since June 2016 but as far as I am aware I have had only 14 episodes all recorded on my Kardia

Most episodes I can link to Covid and ibuprofen - I am on Apixaban and take bisoprolol as a PIP

Out of the blue I woke at 2,00 this morning in AF - I took my normal meds and tried all the relaxation techniques

My question is that I experienced the strangest feelings when going back into NSR and I wondered if that was normal

I suddenly felt very faint (I was sitting up in bed) and then what I can only describe as a thud type feeling in my chest

My husband was about to take me to A&E when I checked my Kardia and I was back in NSR - heart rate then and now 57

I feel ok now but I have never been aware of going back into NSR before

I don’t think I should be concerned but just checking with yourselves

[BobD Volunteer]

Some people report this. I suspect there is a slight pause in heart beat as you transfer from AF to NSR which causes this effect.

[Buzby62]

Yes, I nearly always had the pause when reverting to NSR prior to my ablation. Was quite scary in the beginning but then I used to look forward to it as it was the end of the episode.

Best wishes

[Sandyc2705 in reply to Buzby62]

Thank you for replying - I was quite scared as it’s the first time it’s happened

[fibnum]

I seem to have lower BP shortly before, and a few minutes after, returning to NSR.

[Frances123]

I get these at times and it is called a Conversion or Sinus Pause. My EP said if it is only a couple of seconds and I didn’t faint then just to keep an eye on it. Anymore or any fainting then a pacemaker is considered. He asked me about driving but as I don’t drive the conversation didn’t go any further. In hindsight I’m guessing if I was a driver and pauses were longer I would have to inform DVLA and be declared fit to drive if necessary?

[President2012]

Hi. I was having conversion pauses which gradually became longer and I would blackout (syncope). I had to have a pacemaker fitted which solved that problem. I have had nine since and hardly know when I have converted nowadays. I would consider talking to your cardiologist/EP. Hopefully it will not get worse but it could. Best of luck

[Tricia239]

I used to suffer with this; my EP referred to it as Slow Sinus Node Recovery and arranged for me to have a pacemaker fitted which I found reassuring because it is a horrible and scary feeling, especially if you live alone as I do. Good luck.

[MaryCa]

It's called a conversion pause. I've actually caught one 4.25 second one on my kardia. It's scary seeing a straight line with no pulse on an ecg. It's literally the heart trying to reset. Beta blockers make mine worse.

[MaryCa]

As above

Conversion pause caught on kardia

[Sandyc2705 in reply to MaryCa]

Thanks for your reply - it was a first for me and scary - I felt like my heart jumped

[Rosemaryb1349]

Definitely need to report it to DVLA it's dangerous if you are driving and it happens. I had to have a pacemaker because of this problem. I've also lost one friend in a car crash due to this and another who was the cause of a bad crash and who now has a pacemaker. Wish you good luck.

[Jasod]

Hi, that usually happens if you are on a daily beta blockers and the dosage is a bit too high (slowing the heart rate too much, which induces a larger than normal pause when your heart kicks back into SR). I have fainted in the past when this has happened to me. My EP told me to stop driving! so concerned for my well being he never once suggested a lower dose... Anyway the uncaring nature of EP's is a discussion for another day...

Once i stopped taking beta blockers it never happened again, of course i could have asked for a lower dose but i didn't think it was doing anything anyway.

If you are not on daily beta blockers then that is clearly a concern. It is possible you have an unusually low heart rate which will only be problem when reverting back to SR.

You can ask your EP or Doctor for advice but in my experience they really won't care that much unfortunately.😕

[Sandyc2705 in reply to Jasod]

Thank you for your reply - I don’t take a daily dose of bisoprolol only as a PIP

When my episode started I took two 1.25mg as instructed - my highest heart rate during the episode was 102 (Kardia) and it was 57 immediately after I went back into NSR

[Jasod]

thanks Sandy, at 57 your heart rate is a bit low which would impact the ’pause’ period upon conversion to NSR. My pause was around 3 to 4 seconds which was long enough to make me faint. If I were you I would only take 1 bisoprolol, this should reduce the pause period and make you feel better, and as mentioned in my original post you should discuss with your EP. All the best.