I’ve PAF and am in the midst of trying to find ( however unlikely ) a cure or to find the instigator of my condition. Having had episodes every 6 weeks with a flecainide PIP , in July the cardiologist put me on 2x50 mg a day . Wierdly this seemed to increase the frequency to every 10 days or so within a month … but it’s been a month now since my last and the previous was 17 days . I’m hoping this is a good sign ? ( straw clutching 😀)
On HRV- I got the CardioBot app for my Apple Watch and it’s seems my HRV can be as low as 25 or as high as 110. The internet seems to be about if yours is too high or too low … but not about if you are both ? Anyone know more about HRV ? For someone 57 and very fit with a testing plus of 43.
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Jimbobarelli
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I had PAF it’s now permanent AF I spent years pointlessly looking for a cause and how to stop it whatever I thought was the cause I stopped doing whatever it to find something else caused it. It is a will of its own just go with it. I spending pointless years of your life trying to stop it just causes extra stress and disappointment. I’ve found that living with permanent AF is a lot easier to deal of PAF. My symptoms aren’t as bad now as they were while in the of PAF, but this might not be the case for you.
HRV could be something to do with our parasympathetic and sympathetic systems or trying to find the balance. When you get ectopics and most of the general population get them it can show as a spike in HRV for me HRV pops up about the same time as AF ive seen it as high as 300 and during an AF episode it can go up and down from 60 to 250 during a day. When in Sinus my HRV can range from 15-50 up and down. I think you don't want it sitting low and constantly low. I'm 10 years older than you and have been fit my whole life. Probably why in the first 29 years of my AF journey i only got AF 6 times. Since 2022 another 4 times so my age has something to do with that. I believe we can mitigate the extent of AF but we can't stop it. Look at it holistically with diet and breathing and work with the doctors to enjoy your life even though you get AF. I certainly do!
I have a Frontier X device which gives an ECG and matching HRV. It makes sense that as HRV measures variability in time between heartbeats, it’s going to be high when in AF. Normally high HRV when resting is good, but not in AF obvs.
Here is a graph of a recent AF episode of mine where you can see the HRV is really high in the middle section when I am in AF and lower (more normal) on either side.
HRV is a measurement in milliseconds of how much your beat to beat timing is varying so whilst in NSR it will be normal/low but with any irregular heart beat it can be excessively high. While having PAF episodes mine could be 200-300, since my ablation it averages at low 20s. It’s not to be confused with a rate of any kind, it is just how much variation you are having.
When in AF your HRV will obviously be much higher than your NSR resting norm. Athletes often use HRV as a measure of fitness recovery and so your individual numbers will vary.
I’m a 73 year old woman, not very fit with a pacemaker and other chronic conditions and I am really happy with HRV which runs along more or less straight line of between 30-40, that mean my Parasympathetic/Sympathetic is in balance. When in NSR and I see HRV rise I know I have to destress - which helps me avoid triggering AF. For someone who exercises a lot - that may mean exercising less as stress is created by inflammation from exercise as much as psychological stress and that is why HRV is a useful tool.
I used HeartMath 20 years ago as they were doing a lot of work around using HRV to destress, especially in schools. They have a device which measures electrical pulses at the ear lobe to measure in real time the amplitude and the variability of the heart beat - the goal was/is to reduce the variability to come into balance or ‘coherence’. It worked for me. Like many organisations which grow HeartMath has now become a large very commercial organisation so not quite as generous with their sharing their insights as they used to be but still have some very useful meditative techniques to bring Autonomic Nervous System into balance. Worth looking at Personal Coherece on HeartMath.org.
No real link between HR and HRV but most people experience higher HR when having an AF episode. Some have low HR AF but the HRV will always be up with AF.
Yes. The HRV is the darker orange. Normally, the HRV would be higher with a lower resting HR and low on exertion. But with AF both the HR and HRV are high.
I see, you’re looking at the little blip half way along, the episode starts earlier I think when both go up. Not sure what that blip is but could just be anomaly with the iPhone/ watch. I get some unexplained anomalies sometimes. One theory is that the background HRV check starts while at rest and you get up suddenly to do something half way through it.
Yes, I’ve tried too, I’ve settled on using HRV history just to check if there have been any irregularities as a spike in HRV is always a sign but doesn’t always report in the AF history. Since my ablation my HRV in NSR has been consistently much lower and I feel that’s a good sign. 🤞
I started on Flecainide as a pip and took 100mg when needed. As episodes increased I was put on the dose you are taking and then 100mg twice daily. As I was fine when I forgot the first dose of the day, I suggested ( over the phone to an A&E dr who was doing a shift at the surgery) that I take 50mg in the morning and 100mg in the evening and it has worked pretty well. Of course, as we know, we are all different but it might work for you.
Strangely I’ve just been to the cardiologist and he has upped me from 2x50 to 2x100 daily . Seems I’m “a big bloke” and the initial dosage was likely to not be enough! Probably should have asked if I still take 200mg PIP if I have an episode . Don’t they say 300mg in the max daily dose ?
No experience but I’ve read that 300/day is the absolute maximum. I would be emailing the cardio secretary to answer the question for you as only a cardiologist can prescribe flecainide, GPs cannot in the UK.
I’m on very low dose of Flecainide 20mg twice daily annd low dose metoprolol and if I go into AF I take 150mg as a PIP. We are all different and your doctor should advise what’s best dosage for you
How often are your episodes ? My cardiologist seems to think we go down the route of trying to stop the episodes and that my symptomless episodes plus general heart health negate the requirement for blood thinners or thinking about ablation. Let’s hope he’s right .
Jim have a look at my reply earlier in the thread but I’ve had approx 10 episodes in 31 years of which 4 have been in the last 27 months. I’m keen on the newer Ablation technology which is being trialled. How soon it’s in practice is a guess. They use MRI guided catheters which suggest it’s far more accurate. I’m on the Med route until then. In the event my AF becomes more frequent I will do an ablation at that time
Wow! The same as my experience even though I’m a woman and still slimmish! Yes, 300mg is the maximum daily dose. Let’s hope it works as well for you as it has done for me. And the pip dose is 100mg so very surprised you were told to take twice that amount!
My HRV was 277 last night when having Afib. Doctors tell me to ignore HRV but sorry - it is very true for me that with AFIB episodes my HRV goes up since heart rate goes up and down as well. The high HRV does not last long however. But there has to be a relationship and maybe it is your Vagal nerve having issue which causes AFIB? I am not sure Doctors have an answer. Thoughts anyone?
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