What is Afib?

[Lovedogs1]

What exactly is Afib, is it a fast heart beat or an irregular heart beat, or both. And how can you have it and be unaware of it? I have been diagnosed with Heart Failure, PAF, Tachy/Brady syndrome, and LBBB. I have a CRP-Pacemaker since 2022. Also on all the usual medications. At first everything was ok and I felt really well. I have been discharged to GP care. Just lately I have been experiencing a very fast heart rate which comes and goes, it doesn’t matter what I’m doing it even wakes me up at night. I know that the pacemaker is only for a slow heart rate, and the meds control the rest. At the moment is intermittent, but should I be seeing someone about it?

[Smallbo]

Hi Lovedogs1, Yes, AFib is an irregular heart beat which can go from very low to very high. And it is not unusual for you to be unaware of it. I had no idea that I had it - totally asymptomatic. I too have a pacemaker. I would definitely see my GP at the very least to see whether your meds need adjustments.

[AAJJTt]

There is another forum on this platform dedicated to this subject. Look for ‘Atrial Fibrillation Support’. Very active and supportive community.

[Happydayz17]

Hi, I'm 84 and have paroxysmal atrial fibrillation. I am asymptomatic. I probably do all the wrong things but have managed to survive with it. I'm not recommending what I do to anyone else. For 17 years I have been told to take blood thinners. However, because I am on a number of other medications I decided not to add to the medication pile and take this. I'm still alive and kicking. If you have AF, please don't worry, you can still live a totally normally life.

[56dick19]

Hi I have a fib and regular can fill my heart racing the only medication that stoped it was Amiodone which I had to stop taking due to it giving me a over active thyroid which was off the scale. So now I’m back getting a fib most days and probably some that I don’t fill. I do have a ICD that controls it if it races to fast. I would check with your GP they put me on bisoprolol 12.5 that helps

[sandandkev]

I had my 1st experience of Af last year,felt fluttering and slight pain in heart,was put on bisoprolol and told to get on with it!! As it turned out have large hole in heart and a bit of heart disease- normal for age,now off bisoprolol and can feel when beats go a bit quicker but does settle

[Forgetful]

A fib as others say is an irregular heart beat (meaning you ae not in sinus rhythm). I have had permanent afib for many years. I am fortunate that after diagnosis, I was put on Adizem which controlled the rate and stopped me feeling the erratic beats. To complicate matters I have a couple of leaky valves which cause me to be breathless - however diuretics have improved this situation recently. Please do not resist taking blood thinners! very early on I was on aspirin, but unfortunately this was not enough to prevent the stroke I had in 2011.

It was a serious stroke, but I was very lucky to be thrombolised and made a full recovery without any post stroke effects. I am on permanent blood thinners now and have managed to live an almost normal life (I am 77) If you can see your GP, suggest you ask for adjustment to medication to see if you can stop the feeling of the erratic beats. Also has your medical team suggested intervention to put you back in sinus rhythm?

All the best and try not to worry too much, as stress doesn't help.

[Alfie33]

I'm been checked for that because I keep going very dizzy. I'm having a 24 hour ecg fitted on Wednesday

[scentedgardener]

AF is an irregular heartbeat. I've had paroxysmal for 3 years. Without medication my HR would be fast, but on meds it doesn't rise much. Some people don't notice it, others, like me, can be horribly symptomatic.

[Engineer46]

Hi Lovedogs1,

You asked: "What exactly is Afib, is it a fast heart beat or an irregular heart beat, or both. And how can you have it and be unaware of it?"

AF is a fault with the heart's electrical system that normally keeps it beating in a regular rhythm, known as "sinus rhythm" with the rate rising or falling from time to time in line with the activity being performed.

The basic indication of AF is an "irregularly irregular" resting heart rate. If untreated, the rate is typically above 100 bpm and can be much higher. "Irregularly irregular" means that there is no repeating pattern to the heart rate. It is unlike ectopic beats where a heart beat will come early or late (it feels like a skipped beat) but most beats are in a steady rhythm.

For some people (like me) the AF is not noticed and has no effect on daily life. I take the lowest dose of the beta-blocker Bisoprolol to keep my heart rate below 100 bpm and Edoxaban as an anticoagulant to mitigate against stroke risk (I'm a 78 year old male with permanent but symptom-free AF). For others the AF is disturbing and they may be offered rhythm control medication, a cardioversion (electric shock treatment) or ablation (surgery to block errant electrical signals around the heart).

Your episodes of fast heartrate could be related to AF or Bradycardia. You can check for yourself by taking your pulse during an episode. If your pulse is fast but regular it's probably Bradycardia but if it's fast and irregular it's probably AF. Armed with this knowledge you should see your doctor.

Best wishes,

Paul

[DiyChas in reply to Engineer46]

I am 79 and male.Your description is exactly like mine except my bisoprolol is 2.5.

When was yours first noticed?

Were you really physically (heart rate as high as 185 in your 50s?) in your 30s to 60s?

I am trying to understand if high HR activities might have created the AFib.

[GiraffeSquishmallow]

The NHS describe Atrial Fibrillation as an irregular heart rate that can often beat abnormally fast and sometimes can be considerably higher than 100bpm but this doesn’t have to be all the time and not for everyone. The fast and irregular heart rate can cause problems such as dizziness, shortness of breath, chest pain / discomfort, tiredness and heart palpitations, which can feel like pounding, fluttering, skipping beats, flip flop sensation or beating irregularly often for a few seconds or in some cases a few minutes.

In my experience, everyone I know who has been diagnosed with Atrial Fibrillation in my personal life has had some level of symptoms throughout their daily life particularly when it’s untreated, worsened without treatment or not treated appropriately which is why a diagnosis has often been sought for these individuals. They have either required cardiology consult and / or been to A&E where it has been picked up on an ECG. Their symptoms have usually been tiredness, heart palpitations, dizziness, problems when exercising and moving around etc. but equally these symptoms can be characteristic of a lot of conditions and it doesn’t mean it’s definitely Atrial Fibrillation if someone has these symptoms.

Although I am aware that sometimes it doesn’t cause any symptoms and people can be unaware that their heart rate is irregular which means it can sometimes go untreated for some time.

I would definitely advise you go and see a qualified medical professional e.g. your GP, specialist, cardiologist if you have one especially with your complex medical history, it definitely sounds like you need to be reviewed to make sure that all your medications are working effectively and that you don’t have another type of arrhythmia such as Atrial Fibrillation because something is obviously happening for you to be experiencing episodes of a fast heart rate throughout your everyday life. It’s so important to be safe and get things treated and assessed as soon as possible, just incase. If you’re particularly concerned, heart rate is very high for long periods, having chest pain, shortness of breath or feeling very unwell please either call an ambulance or go to A&E to be checked over, get an ECG and bloods etc. or contact NHS 111 for advice.

Hopefully it’s nothing serious or concerning and it’s just characteristic of your existing medical condition or a medication side effect but without the relevant tests and clinical knowledge it would be impossible to know for sure. I wish you all the best and I hope you are able to get some advice regarding this.

[GiraffeSquishmallow]

I know that AF can be more common in those over 70 years old, with many relatives now diagnosed, also if you have had cancer treatment such as chemotherapy etc. or certain other medications, can potentially cause an irregular heart beat in later life.

Normally the most effective way to diagnose AF is to have an ECG, Blood tests & a chest x-ray to rule out any other causes for Atrial Fibrillation, a Echocardiogram and potentially a 24 - 48hr ambulatory ECG if abnormalities are detected or suspected but it’s not originally picked up on the resting ECG. You will need to be referred to a cardiologist, normally an electro physicist cardiologist who specialises in electrical disturbances of the heart for further specialist testing, although your GP can support in managing the condition and can offer an ECG at your GP practice.

Some people can be well managed with medications and have a good quality of life, fairly symptom free once treated e.g. beta blockers and blood thinners, but others may require procedures such as catheter ablation. Every case is different and a cardiologist would be the best equipped to advise and support with this.

[A246]

Yes my friend, immediately please. It is irregular heart beat as already stated. It can be dangerous if not treated. My HF diagnosis started with very fast AF. I am on digoxin and bisoprolol beta blocker and apixiban. It is now under control. U will feel better once this is sorted. Don't ignore it your heart is weaker now and under too much pressure. Don't wanna scare you. Get it sorted please.

[Friendliarthur]

Just to put a slightly different explanation of AFib than most of those above, because you asked “what actually is AFib”.

AFib is actually a breakdown in the normal electrical pathways in the heart which stimulate the top and bottom chambers to pump blood in a very coordinated complementary manner.

The result is that other uncoordinated, aberrant, haphazard electrical pathways develop which upset many aspects of normal heart function, including the HR, the rhythm and ultimately the ability of the heart to efficiently pump blood. The aberrant pathways negate the proper role of the normal electrical parthways.

There are differences in how and where the aberrant electrical impulses spontaneously originate but most commonly it is where the four pulmonary veins enter the left atrium. Ablating those four sites fixes AFib for some, but not all.

If you google it, there are many really excellent videos online showing normal electrical pathways in the heart, and showing the jumbled and erratic pathways that characterise AFib.

Good luck for the future.

[Art-99]

About five and a half years ago my erratic heart beat was detected following an ECG , I'd had no symptoms . I was referred to a cardiologist who discovered a leaky mitral valve and prescribed anti coagulants and beta blockers. A year and a half later the mitral valve was replaced and I assumed I would no longer need to take anti coagulants but have been told I must take them indefinitely due to severe arrhythmia. There is a very good booklet mentioned on this site recently produced by Arrhythmia Alliance which explains the variations in this condition, possible treatments and medication.

[grusgrus in reply to Art-99]

I was recently diagnosed with tachy/brady syndrome characterised by alternate 2-4 day periods of slow regular heart beat followed a similar period of faster irregular beats with the transition from fast to slow being accompanied by lightheadedness. This was confirmed by a 14day heart rate monitor which showed heartbeat pauses of up to 8seconds at these transitions. My prior treatment with bisoprolol for AF was stopped immediately until a pacemaker was inserted to control the slow heartbeat and bisoprolol then restarted at 1.25mg daily in an attempt to control the fast heartrate. If that dose does not deal with the peaks in heartrate the intention is to increase the dose of bisoprolol until it does. It seems to me that you should consult your GP about an increase in your bisoprolol dose. Good luck.

[Art-99 in reply to grusgrus]

Thank you for your response. I have twice yearly check ups with my cardiologist and stopped taking beta blockers about two years ago, with his blessing. My blood pressure has always been pretty well behaved and I check it regularly at home. I was referred for an angiogram last year as I was concerned about more noticeable heartbeats at night. Wore a holter monitor for 24 hours, referred for an angiogram and was fitted with a stent and currently taking clopidogrel , so I assume this will discontinue at the end of the year. I shall however ask on my next visit if there is any advantage, in my particular case, in resuming bisoprolol.

[grusgrus in reply to Art-99]

. I have no blood pressure problems , the bisoprolol is solely to reduce heart rate peaks. I intensely dislike taking bisoprolol, it saps my energy and stamina but if that’s the price of avoiding a stroke then I put up with it. Good luck.

[Jedi14]

Yes. See your GP about it!