Hi there. I'm quite new to everything and looking for a wee bit of advice please? I passed out last May 2024 and was diagnosed with Afib and put on a low dose of bisoprolol. I seemed to be ok, a bit tired but no more passing out. Then in December 2024, I passed out again l, so back in hospital and this time bisoprolol increased to 2.5 mg per day and also Flecainide 50 mg twice per day. I've felt fine again but this morning I felt palpitations and my Apple watch saying my heart rate was 178 BPM. After a minute it went back to around 70/80 BPM. Is this common or should I be calling the doctor? I'm wondering if I wouldn't be so worried if I didn't have the watch to look at! Any advice much appreciated. I'm 48 and always been in good health until last year. Thak you.
New to Afib and experienced very brie... - Atrial Fibrillati...
New to Afib and experienced very brief spike in heart rate
Rapid variations in heart rate are a symptom of AF so your experience is quite normal. Unless you have chest pain or fainting doctors are not important. Stay well hydrated and rest till it passes. Why not go to our main website (Atrial fibrillation Association) and read till you drop and then come back and ask whatever you like. AF is a long journey but we are all friendly travellers.
Hi BobD. Many thanks for your reply. I'll definitely have a look at the Atrial Fibrillation Association website. Although my heart rate was high, there was no chest pain or dizziness like the last time. I just got a bit of a fright. So true about keeping hydrated, I feel that drinking more water and less fizzy drinks has made a definite improvement. Now to get back to the exercising! I feel my Afib is maybe a result of stress, so trying to manage that better. Thanks again for your reply and all the best to you. 😊
Hiya Maz67,
I can only make generalised comments based on my quite dated experiences. I was first diagnosed in January 2010 with paroxysmal AF with the tendency to be asymptomatic. So, against this background, given your age, I think with the correct treatment from an EP you stand a pretty good chance of getting this thing highly controlled so that you wil return to the good quality of life you have been used to.
One thing though ....... don't focus too much on your heart rate ... nor too much on an Apple Watch. Never forget that blood pressure comes into the equation ( and you don't mention that at all ). Generally speaking, a fairly normal BP is around 120/80 (depending how fit and athletic you are ) and heart rate between 60 and 100 bpm.
When my AF mugged me over a period of 9 hours my blood pressure dropped down from 136/90 with a heart rate of around 64 down to 76/50 and my heart rate shot up to 156. If you follow posts on here you will find that AF is/can be - all things to all people.
Back in 2010 treatment plans were NOT quite so advanced as today and I was on the receiving end of the bog standard Bisoprolol 5mg, Statins, and Warfarin - they later added Felodopine 2.5mg to the mix. Felodopine is a blood pressure control drug, and Bisoprolol also has some properties aimed at controlling Blood Pressure but mainly it controls heart rate. BP and AF tend to go together in many folk. I was offered ablation but back in those days I regarded that as something like 'Dark Arts' and very firmly declined opting instead to go the medication only route to problem solving - which it has done.
These days my approved medication is Sotalol 40mg in morning and 40mg in evening, Warfarin, Statins, and Felodopine.
Good luck in your journey. 😂
Thanks for your reply BenHall1. 😊My blood pressure tends to be a bit on the lower side. If I'm right, the medication for Afib lowers the blood pressure, so not so great if you already have low blood pressure? I'm obviously just finding out about all this and more research needed on my part I think! 😁
I was quite light headed when I initially started the medication, but after a couple of months that seems to have calmed down. I've also cut out almost all caffeine and drinking lots more water. Trying to get back to exercising, more big walks rather than anything too intense.
The hospital are sending me out information on ablation. I reckon that I'd rather continue with the medication (for now anyway).
I just got a bit of a fright when the Apple watch showed a heart rate of 184 BPM yesterday, which went down to 70 BPM again after a minute or even less. I'll take on board not to pay too much attention to the watch, aware it might make me more anxious!
Thanks again for your reply. All the best. Maria 😊
Hi there. I was 54 when I had my first afib episode. So similar to your experience, as I too have low BP (110/60) HR 60 I am taking 1.25mg Bisoprolol and it seems very effective. Only ever had 2 confirmed AF episodes, but a 14 day zio patch revealed non sustained SVT. This is a sudden elevated HR which quickly drops back. It could be more SVT for you than AF? Have you been offered a heart monitor? The longer duration give a marvellous picture of what the heart is up to. I have eliminated caffeine and alcohol and take a brisk daily walk, nothing adventurous. Ablation was not for me either.I have found the whole matter stressful and my EP believes stress ( plus two covid infections) are the root of the problem. You should try to have confidence that all will be well, you are not alone xx
I think it's worth monitoring your BP. Bisoprolol is likely to lower it. I see you're also on Flecainide now. Did that improve things for you? Without being obsessive, keep am eye on your symptoms and log anything relevant. There's a range of different medications for AF and it may be you haven't yet found the best fit for you.
My occasional AFiB episodes involve a sudden increase in heart rate to c. 200bpm for up to half an hour (usually triggered during the resting phase after excessive aerobic exercise). I then revert without intervention to 100bpm and get back to normal, Bisoprolol 1.25mg lowered the max during an episode to c. 180bpm, but I didn’t see the point and it disagreed with me, so I abandoned any rate control drug. I prefer to put up with an occasional short AFiB episode than have the constant drag of a betablocker on my activity.
Do you have another device you can use to confirm your high rate? I have a Fitbit (Sense 2) and have seen spikes as well. One time the watch said rate was over 150 bpm, but when I was able to compare it to a BP and a pulse oximeter they both agreed on a reading in the 70's. After doing some research, apparently readings on the Fitbit can be altered if the fit isn't right or your activity changes quickly. Not sure if that applies to Apple but may be worth checking. Now I tend not to get alarmed by spikes unless it lasts a few minutes or if I see it on the actual Fitbit App on my phone or if another device agrees. Just my experience.
Hello, you might want to ask for an MRI of your heart. That is how they found out I had some scare tissues. I passed out twice when I was in Afib, the second time I went into cardiac arrest, luckily I was hospitalized for rapid afib. 2 days later I had a pacemaker/defibrilator, it was 4 years ago, when I was 56, I have been sinus rhythm since about 98% of the time
Hi, my question is would you have noticed HR without watch. I'm generally asymptomatic and so don't always notice if I go in and out of AF. If it persists I may notice breathlessness or feeling washed out and will check on my BP monitor, it will find difficulty registering pulse or BP and then get GP to check. I tend to think that watches/devices can cause more stress than they are helping. I mean what are you going to do if the watch says your HR is high, spend days in A&E?
could be low blood pressure or lack of hydration. Can you check your watch Health App on your phone and see what HR was at the time of passing out? maybe HR going too low from drugs. I was nodding off all the time and my metoprolol and flecanide were halved and now no issues. My normal HR pre-drugs is around 60-65 and was going down to 40 on the higher doses.
BTW i'm 67 and was first diagnosed at 35. For first 29 years AF only visited me once every 4 or 5 years. Last few years its about 4 episodes but otherwise all fit and healthy!
I'm not a medical professional but personally, I wouldn't be too worried about spikes in heart rates produced by a smart watch. These devices are prone to errors due to watches moving and/or extrapolating irregular heart rates recorded over a short period into BPM.
However, I would be concerned if excessively high heart rates were showing for sustained periods of time. You should consult with your medical for guidance about when you should be concerned i.e. above what BPM, for what period of time and using which method of measurement. I use my watch's ECG function and/or my KardiaMobile 6L to confirm I'm in AFIB and my HR during episodes i.e. rely on HR produced by ECG rather than standard method used by Smart Watch's. The ECG's are both generally performed over a 30 second period (same for Apple Watch I think) and I believe they are more accurate than your watch's basic HR monitor function.
If your HR meets or exceeds the thresholds set by you medical professional then he/she should also advise what what action you should take if that situation ever arises. Ditto if your episodes are accompanied by symptoms your medical professional advises you should take action in response to.
I used to be concerned about my AF episodes before I was diagnosed with AF. They resulted in a several visits to ER before it was eventually captured on ECG. I still have the occasional episode, accompanied with higher than normal HR and palpitations but I haven't been back to ER since. I know what is "normal" for me and my episodes haven't exceeded those thresholds set by my cardiologist.
Having those thresholds set for you by your medical professional should assist you greatly in coping/managing your episodes.
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