Severe arrhythmia but only minor symptoms

[Art-99]

This is the first time I’ve posted on this particular forum rather than BHF. During a routine checkup in 2019 I was found to have an erratic heart beat, I’d had no symptoms, Chest pain or breathlessness. Subsequent investigations found a leaky mitral valve . I was placed on anti-coagulants, my condition and INR monitored and in September 2020 had OHS to replace my mitral valve. On my recent 6 monthly checkup with the cardiologist, I asked whether having had the leaky valve replaced did I need to keep taking blood thinners, he replied that I will have to take them indefinitely because of my ‘severe arrhythmia’ . Tbh the only time I’m really aware of my heart beating haphazardly is when I’m in bed and lying on my left side; has anyone else had similar experiences?

[Yumz199725]

Hi Art-99.A very warm welcome to the forum. So your on anticoagulants for your severe arrhythmia have they suggested anything else to control the arrhythmia? I ask cause I am on verapamil 40mg for ventricular Tachycardia and I do notice when I lay on my left side my heart is going crazy so I prefer to lay on my right side but always wake up laying on my back 😅. The mitral valve leak must of been severe for them to replace it or was it just a slight leak but severe symptoms. Sorry about all the questions. I ask because I have bicuspid aortic valve and severe aortic regurgitation and moderate stenosis and will need replacing eventually so just wondering what symptoms you had? Besides the arrhythmia. Alot of other members can probably shed some light on this better then I can 😅. Sorry for confusing comment 🙈.

Take care ❤️.

[Art-99 in reply to Yumz199725]

Thank you for your reply. I should point out I live in Cyprus at the moment, which is also where I was diagnosed and had valve surgery. Other than warfarin and beta blockers from the outset I have never been prescribed anything for arrhythmia; it's only recently I've begun to wonder why if the problem is severe I'm not on some sort of prescribed medication. I no longer take beta blockers and my blood pressure varies between optimal and normal most of the time. With regard to the valve surgery, whilst not an emergency, it was not improving, hence the replacement valve. I must admit I assumed the prolapsed valve was the cause of the arrhythmia but it seems this was not the case.

[Hidden]

Hi, With regard to your new valve, what type is it, as that can have a bearing on taking an anti-coagulant.

Best Wishes

[Art-99 in reply to Hidden]

Initially having been told it was an artificial valve I assumed it was mechanical, but subsequently told it was synthetic/biological ! Bearing in mind I had my op in Cyprus I think some things are lost in translation. Even so I now understand the continued use of anti coagulants is down to arrhthmia.

[Hidden in reply to Art-99]

Hi, It was just in case you had a Mech valve, in which case you'd need Warfarin, unless Cyprus have different approvals for anti-coagulants to the UK.

[jeanjeannie50]

I've had AF for 18 years and know not to sleep on my left side in bed, or it will trigger an attack.

Jean

[Engineer46]

Hi there. I envy you living in Cyprus avoiding the cold damp English winter - and spring this year too! I imagine that it may sometimes be difficult translating medical language.

What you describe as "severe arrhythmia" is probably what would be described in the UK as "persistent atrial fibrillation". I have that condition and like you, suffer no symptoms.

It usually means that your heart rate is irregular and unpredictable ("irrregularly irregular"), so there is no pattern to it. It is also seen on an ECG by the absence of "P-waves".

There are many on the forum with this condition and, when there are no symptoms, usually no surgery (cardioversion or ablation) is suggested. Instead, one is given a beta blocker to reduce heart rate (if it is too high) and an anticoagulant to reduce stroke risk. While you have atrial fibrillation it is important to continue taking an anticoagulant.

Many of us now take the new anticoagulants such as Apixaban and Edoxaban rather than Warfarin, as INR tests aren't required, just a blood test every six or twelve months. However, you may not have this option due to your valve replacemen and others may have a view on this.

As your AF is probably persistent (with you all the time), I suspect that what is happening when you sleep on your left side is that you are hearing your heart beat more clearly than when you sleep on your right side, because the left ear is closer to the heart and the beat sounds louder. That's how I first noticed that I had AF myself. I don't think that the position makes any difference to the AF itself.

Best wishes,

Paul

[Art-99 in reply to Engineer46]

Thank you, what you have said certainly makes sense; I’ve never heard my cardiologist refer to afib , just arrhythmia, whereas it’s seems the opposite in the uk. I am concerned that I haven’t been prescribed something to help control/moderate my heart rate, particularly as he sanctioned my stopping beta blockers. With regard to warfarin, I have been readingthat it’s use is far less common in the uk, following the introduction of alternative and more convenient anti coagulants. I intend to ask him about that when I submit my blood tests in about a month.

With regard to the weather it’s somewhat overcast and muggy today, I never look forward to July and August here, way too hot for me and usually escape to the uk for a couple of weeks.

[Engineer46 in reply to Art-99]

Whether you need a beta blocker or not depends on what your resting heart rate is. If it's under 100 bpm you may not need one. Generally speaking, a beta blocker won't cure the arrhythmia, as it is designed for rate control rather than rhythm.

Best wishes,

Paul

[wilsond]

Many people walk around with asymptomatic AF,they're blissfully unaware they are a ticking bomb waiting to go off! AF raises our stroke risk by 5times average plus they are the most devastating type as travel very quickly to brain.

We are the 'lucky' ones with a diagnosis and some protection. Xx