Is it AF or just ectopics

[Qualipop]

Around 6 weeks a g o my BP monitor showed erratic heart rate for 5 days, every time I took it. Pulse was the usual 80s, BP was around 124/72 but when I felt my pulse it was constantly very erratic; missing about every 3rd beat. I went to Urgent care who did a 30 second ECG and said it w as atrial ectopics. SInce then have spoken to head of urgent car who says no, it was ventrical. Rang GP who booked a 24 holter monitor over 2 weeks ago without seeing me; unfortunately the leads came loose after a few hours. Saw another trainee GP a month ago who seemed very thorough, said she could hear all the missed beats, booked an ECG by the nurse who actually did two because the first one missed them. She showed me the readout and also said atrial ectopics.

Since a month ago absolutely not a word from anywhere. They are far more noticable now ( I'm more aware) . I go dizzy when I stand up,; by the time i walk to the kitchen i'm gasping for breath. My BP is now all over the place from 108/50 to 131/75.

I was spoken to by a different GP to the one i saw so have no idea who to contact. Tied phoning GP today, 20 times. IT just rang and went off. FInally got through and have a phone call from "someone" around 4.30 today. Heart is s till missing between every 3rd and every 5th beat 14 hours a day and i feel dreadful.

Any ideas? I joined the AF forum but reading posts it doesn't sound like AF because my heart isn't racing. Several doctors have said atrial ectopics, 3 others have said ventricular. Surely it should be obvious on an ECG.

[Hidden]

With the caveat that I’m not medically qualified. Ectopics are not actually missed beats, they’re premature contractions, so the beat comes early which gives rise to the sensation of a missed beat due to the longer gap to the next one. They’re only considered an issue if you’re having a burden of more than 10%, regardless of whether that’s atrial (PAC) or ventricular (PVC), or if you’re having runs of 3 or more ventricular ectopics without a normal beat in between. The only way to know for sure both the type and burden would be to have a holter for a couple of days. For arguments’ sake, though, if you’re genuinely having an ectopic every 3rd beat, and even if only for 14 hours a day, then you would almost certainly be way over the 10% threshold and be eligible for treatment. We do know that once people start noticing having them that they become primed and end up noticing more, and they’re an adrenaline mediated occurrence: the anxiety that occurs with noticing them leads to experiencing even more due to the adrenaline pumped out. It’s a vicious cycle. We also know that there are substances and situations that can increase the frequency of them, which amounts to anything that will prompt the body to produce more adrenaline, for example caffeine, chocolate, nicotine, alcohol, fermented foods, certain medications, stress, anxiety, lack of sleep. Lifestyle changes don’t work for everyone, but they can help. There are also other factors like hormones, positional impact, and irritation of the vagus nerve from eating.

In your shoes, I would be pushing for a holter, and also looking at lifestyle factors: changing diet and habits may do nothing, but as ectopics appear to be giving you problems, it’s definitely not going to make the situation worse. You could also ask the GP about a beta blocker, but whether or not they’d be willing to do that without confirmation from a holter is a question mark.

[Qualipop in reply to Hidden]

I did have a 24 hour holter two weeks ago but he leads detached. I just had a phone call from the GP who said MOnitor worked for 8 hours before it came off. It showed 3000 atrial ectopics and 2000 ventricular ectopics putting me at high risk of atrial fibrillation with associated risks. He's giving me a betablocker ( Not bisopralol. I had to stop taking that after HA as my BP dropped through the floor and I had hallucinations) to try to calm them down and I have to go on Friday to next see a trainee doc I saw before to check my BP and also investigate pain in my hip and groin. He is also contacting a cardiologist for advice.

The biggest factor you mention above is lack of sleep and stress. Stress from a husband who just considers me a nuisance, has never believed the amount of pain I've been in for 30 years and won't help, even to drive me to the doctor and the constant severe pain from my spine which wakes me every 2 to 3 hours. Oh and went back to bed when I was taken in with a HA because he didn't believe it.

-- Thank you very much for your reply. It's very helpful.

[Hidden in reply to Qualipop]

Assuming an average hr of 80bpm, over 8 hours your burden was around 13%. If your average hr is lower than that, that would push the burden up even higher: you need a proper holter (i.e. one that works for the desired period) and to be seen by cardiology. An ablation might well be appropriate.

I’m sorry your personal situation is the way it is. I have no words of wisdom there, or none that I feel it’s appropriate to offer as a stranger. But safe to say it’s not going to be helping your physical health, and I can empathise somewhat. I ultimately decided to get divorced and become a single dad when my ex was behaving similarly. Not like I was any worse off for it 🤷‍♂️

[Qualipop in reply to Hidden]

My average heart rate is between 80 and 90; towards the higher end which would bring the burden down a bit but still high. Their decision on trying medication seems to be based on whether you are symptomatic or not. I didn't feel them at all at the start but obviously once the BP monitor showed them, I became more aware of them but I was feeling rough before that. which was why I started checking my BP. I have suspicions as to why they s tarted but I won't mention that here.

[Hidden]

Hello

I have no idea but what a mess they seem to be making and meanwhile you are suffering not knowing which it is

I am glad you are getting a call later and wanted to let you know I had read your post and I hope you get some answers when they ring you back x

[Qualipop in reply to Hidden]

We must have replied at the same time. See my reply just above yours.

[Hidden in reply to Qualipop]

Hello

Yes we must have been replying at the same time

Glad you got a call back and glad they can see something needs doing !

I hope the Beta blocker helps and to be honest I forgot to take one just a day and my heart beat shot up in the 90's and now I see they do work as when I took one withing a hour and a half it had come down to 60 thank goodness

I hope you will be able to get the prescription as soon as possible so you can get started on them and I did read about your Husband and it is no good when they are not believing what we are going through but we know and hopefully our replies let you know we care and understand

Keep us updated if you have time will be thinking about you x

[Qualipop in reply to Hidden]

When I Had betablockers ( Bisopralol) after my HA it caused hallucinations and dropped my BP through the floor. The trainee GP I saw a month ago is superb. The GP I spoke to today is he one who ordered the holter monitor but because no one had got back to me about any results he wants to be taking charge of treatment so there's some continuity. About time.

[Hidden in reply to Qualipop]

Hello

This sounds positive and good news

Glad someone is taking charge now and will see you through this till they get to the bottom of it and the right treatment which you deserve x

[Qualipop in reply to Hidden]

Thanks; continuity of care has been lacking for a very long time.

[Hidden in reply to Qualipop]

Hello

I agree but thank goodness you have it now x

[Qualipop]

Thanks but as i said the holter showed what's happening although not why. Health is a problem. Excercise is impossible. I have at least 8 discs gone in my spine, scoliosis and spondilolystheseis which is a vertebra right out of line; constant severe pain which affects sleep as well. I can only stand up about 3 minutes before the pain gets too bad. After HA rehab refused to take me and insisted I wouldn't be able to do it.

[susieanna]

oh my God. What a nightmare. But tbh it don’t surprise me. If the Drs don’t understand the readings then why are they not referring you to Cardiology ?? If you are getting dizzy and feeling terrible then I would have demanded a referral. One saying one thing. And another saying this.

As I said it don’t surprise me though. I think you should demand a referral to Cardiology. The least the Drs should have done is send your reading to the Cardiologist for his expert opinion. And advice. I mean what do they expect you to do now ????

I’ve just had an ECG. And panicked when it said abnormal. And stuff written down. I had to lie to get to see a Dr. ( each time I go it’s never the same one ). I could tell she didn’t know much about it. At least she sent my reading to Cardiology for their opinion. I would demand a referral. You need to feel reassured. And you need to know exactly what’s going on. Oh Good luck.

[Qualipop in reply to susieanna]

I thought I'd said he is contacting the cardiologist for his advice; probably quicker than sending me in person. Cardio appointments here take months.

[susieanna in reply to Qualipop]

months !!!! That’s crazy.

[Visigoth]

I too had severe ectopics and felt absolutely terrible. Then I started getting episodes of paroxysmal AF, although I didn’t know that’s what they were at the time. The anxiety induced by not knowing what was going on didn’t help, so I downloaded the FibriCheck app and used that whenever I had symptoms. Initially I paid for a service whereby a medical professional reviews the readings but after a while you know the patterns and you can understand the readings pretty well yourself. The good thing is that the reports are colour coded by severity but also tell you whether the ectopics are bigeminy, trigeminy etc. You can download them and email them to a doctor. When I eventually was given a monitor, the readings from the FibriCheck app matched the monitor readings exactly, so I believe it to be extremely accurate. Since seeing a cardiologist and being put on medication, both my AF and my ectopics have been controlled superbly. Of the two, it was the ectopics that made me feel dreadful, since they were almost constant.

[Qualipop in reply to Visigoth]

This isn't AF yet; just a LOT of ectopics. Can I ask what meds you were given for it that calmed them down? HOw does that App work? On a phone or a special machine? What is it that actually takes the readings?

[Visigoth in reply to Qualipop]

I was put on amiodarone. I know it doesn’t suit everyone and can have toxic effects but it has improved my quality of life 100% and I’m praying that will last! FibriCheck is a phone app that works by placing your finger on the phone in the right place.

[Qualipop in reply to Visigoth]

Hmm, my phone may be too old for that but I'll have a look.

[Qualipop]

Hi II322, it appears your reply was deleted. If you were suggesting menopause, I had a hysterectomy 34 years ago LOL.