Is this AF?

[Sandych55]

I have paroxysmal AF, and up til now it's been 10 - 12 months between episodes and I normally know what has caused it - usually stress. I had an episode on Monday - stress related - but I am having another one at the moment which feels different. I normally have fast AF. On Monday it was an average of 125 which went after 2 hour after taking flecainide(100). Today the trace on my monitor looks normal in between the irregular 4 or 5 beats I have per a minute. Is this still AF? I took a flecainide four hours ago but it hasn't resolved yet. Heart rate is an average of 75 beats a minute.

[BobD Volunteer]

I can clearly see many P waves so most is not AF.

[mjames1]

Not afib. Looks like a normal ekg with PAC's. This is not unusual at least for me after an afib episode, until things start to calm down.

One way you can tell is that the P waves are pronounced, and it's actually regularly irregular as opposed to irregularly irregular. The latter being the hallmark of afib. The shortened premature beats (PACS) are always followed by a longer compensatory pause, therefore regularly irregular.

Did Kardia tell you it was afib? It sometimes makes mistakes when there are multiple ectopics. Of course, none of here are doctors, so you can always run it by your EP. Or one of Kardis's Cardiologist for a reasonable fee.

Jim

[Sandych55 in reply to mjames1]

My machine (an Emay) said it was arythmia. It feels different to Afib but just as uncomfortable. I've just seen the doctor who has sent me to the hospital assessment unit. I don't have an EP. Not sure we have any in Derby and only saw a cardiologist once after my first episode 3 years ago

[mjames1 in reply to Sandych55]

If anyone tells you this is atrial fibrillation, I would insist on seeing an electrophysiologist. They are trained to analyze an EKG. Most GP s and even many cardiologists are hopelessly lost without looking at a machine interpretation. Good luck and let us know how things work out.

Jim

[mjames1 in reply to Sandych55]

PS if you run into a problem getting this analyzed without an electrophysiologist, you can always try to get a remote 2nd opinion with one. Also, if you want to get a Kardia, they offer a reasonable fee based service where a Board-certified cardiologist will analyze your EKG via email or phone.

Jim

[Sandych55]

So the doctor says it's basically ectopics. My blood pressure is really high but it always goes through the roof when I'm worried. Normally it's fine. If they don't subside they might alter my Tildiem dosage but it's already 90 twice a day which I understand is quite a substantial dose anyway. Waiting for blood test results to see if anything else going on but if not they are sending me home.

[mjames1 in reply to Sandych55]

I'm glad you've been reassured that it was not atrial fibrillation. Ectopic beats like your EKG shows is fairly common and usually does not require any kind of treatment.

And as I mentioned, you are even more prone to ectopics after an agib episode.. I certainly am.

Tildiem (Diltiazem) might help a little, but not necessarily. However going on daily Flecainide for a few weeks or a month might produce better results. The daily Flecainide also make it less likely that you will fall back into atrial fibrillation during this period where your heart is still agitated. Let's so with the Diltiazem which is a weak anti arrhythmic.

Jim

[Sandych55 in reply to mjames1]

I'm already on Tildiem 180 a day. I feel so uncomfortable I don't know what to do with myself. I'm not eating and don't feel like doing anything. Ho long do yours last?

[mjames1 in reply to Sandych55]

Ask your doc if you can cut down on the Tildiem, and maybe you will feel better. I've had ectopics like that last thing for to days. They are really harmless. Daily Flecainide often helps with them. Again speak to your doctor.

Jim

[Whataperformance]

You have Sinus Rhythm with Atrial ectopics that's Normal for everyone.Don't worry.

[Sandych55 in reply to Whataperformance]

Unfortunately I am having a lot. It's really uncomfortable - worse that Afib -and I feel light headed and can't concentrate on anything. I'm hoping that they will eventually stop and revert to my usual four or five an hour.

[Singwell in reply to Sandych55]

Hope you're doing a bit better now. I'm glad someone suggested you're having atrial ectopics- also called premature atrial contractions. I get these and my EP told me it's AF trying to kick off. And - like you - I find them really uncomfortable. Worse than AF in some ways. I do find that Flecainide helps to get rid of them (I take pill in the pocket) but otherwise it's best to sit them out. I find doing something low key but engaging helps - the last few times they've gone on their own. As Jim says - not dangerous. But a blooming nuisance!

[Ppiman]

The trace shows the heart's natural pacemaker cells, the Sino-atrial node, are working well and causing the small "blip" called a P wave just before the peak from the ventricles contracting. There are some premature ectopic beats, likely PACs, showing which, I would think, caused you to feel palpitations. The few pauses ("missed beats") are not the same as the irregularity from AF but are called "compensatory pauses" and often follows a premature beat like a PAC.

Steve