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Heart Disease (Expert Forum)
Afib or Tachycardia?
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Afib or Tachycardia?
by JASG, Dec 30, 2006 12:00AM
I have been diagnosed with atrial fibrillation and am scheduled for an ablation next month. The diagnosis came in 2005 during an atrial flutter (typical & atypical)ablation in 2005. I have highly symptomatic episodes where my heart rate will often get up to 225 bpm. Other times my ventricular rate will vary between 150 - 180 bpm. Is this common for atrial fibrillation? I take 50 mg of atenolol daily and am suprised to see rates so high. All of the literature indicates rates up to 180 bpm with afib. I am concerned that I have some other rapid atrial tachycardia that will remain after my ablation. thanks for your assistance.
Doctor's Answer
by CCF-M.D.-MJM, Dec 30, 2006 12:00AM
Hello JASG,
I am sorry to hear about your diagnosis. My first advice is to make sure that the person performing the procedure is trained to do them and has done many of them -- at least 50 to 100. I say this because many physicians haven't been formally trained and all the studies showing high success rate are at experienced centers. Experienced centers are also more equipped to handle the potential complications.
Atrial tachycardia, atrial flutter, and atrial fibrillation often coexist in the same patients. If your fast rates are irregularly irregular on the EKG, the diagnosis is almost always atrial fibrillation. It is much easier to know for sure once we have catheters inside your heart. Faster rates in atrial fibrillation are most commonly caused by increased sympathetic tone (stress, adrenaline) and its effects to speed conduction in the AV node. Rarely an accessory pathway will cause conduction at these rates, but this should be apparent during your ablation and usually on your resting EKG.
Good luck with your procedure. Thanks for posting.
I am sorry to hear about your diagnosis. My first advice is to make sure that the person performing the procedure is trained to do them and has done many of them -- at least 50 to 100. I say this because many physicians haven't been formally trained and all the studies showing high success rate are at experienced centers. Experienced centers are also more equipped to handle the potential complications.
Atrial tachycardia, atrial flutter, and atrial fibrillation often coexist in the same patients. If your fast rates are irregularly irregular on the EKG, the diagnosis is almost always atrial fibrillation. It is much easier to know for sure once we have catheters inside your heart. Faster rates in atrial fibrillation are most commonly caused by increased sympathetic tone (stress, adrenaline) and its effects to speed conduction in the AV node. Rarely an accessory pathway will cause conduction at these rates, but this should be apparent during your ablation and usually on your resting EKG.
Good luck with your procedure. Thanks for posting.
Recently in the ER diagnosed Paroxysmal AF/AT. My cardio ignored it, he said is anxiety. I went for the second opinion cardio in November. Unfortunately, he didn't want to take me because I presented there with V-Fib. The new cardio said my wpw hasn't fixed yet (can tell from the ECG) but my old cardio said it fixed!
I also feel there is a "train" and an "elephant" hiding in my chest. It vibrates.... Cold and "ghostbumps" on and off even on a hot day 33 degree. Heavy pressure makes me can't breath! My life is a dizzy life, all the time dizzy, pressure gone up to the head, Dr said is anxiety too. Do you have those symptoms as well? Can you share? What is your symptoms? Are you taking blood thinner or aspirin?
Please let me know how your ablation goes? What kind of ablation are they? Where they ablate?
Thanks
Pika
I would be very concerned with the vfib diagnosis. Sounds like you need to go to one of the top centers (Cleveland, Marin, Bordeaux)for a touch up. I'm having mine done at UCLA. If this one fails I will consider Marin or Cleveland. Good luck.
The new cardio was post graduate at the Cleveland Clinic Foundation in Ohio USA. He doesn't want to take me as his patient. Although he said was V-Fib but the letter he wrote to my GP didn't say like that. He said my rhythm is complex.
So who is going to fix? Fix what? Anxiety? I believe the V-Fib won't be existing all the time, if so I think I won't be able to sit here and post! I try again, may be I would explaint to the new cardio. That day just a bad day. Ask him to give me another chance and see what he can do for me. If he refused, I have to live with my life until one day that I can't wake up (die of anxiety)....
Pika
I get a lot of vibrations too in my left side of chest. Sometime it feels like there's a wrestling match going on. Most of the meds I've tried made things worse. So mid February I'm having an ablation for VT, in Pittsburgh PA.
Best advise about your cardio is to get an Electrophysiologist. When my cardio started on that anxiety ****, I told him my EP had ruled it out. He no longer brings up that subject anymore. I also told him that I have a psychiatrist in the family that has also dismissed anxiety (this is a lie); but it works.
I hope your ablation is successfull and that you are made whole again.
No one said ablation to me. The old cardio told me is "anxiety" or "stress". It seems I've to go back to him to continue listen the words again and again... unless I keep my mouth shut!
I tried the anxiety med, it made me sooooo sleepy! I even can't look at the traffic light was green or red? NO accident yet but a lot of emergency brakes. If i'm continue taking that I think I'll die in car accident quicker that my heart stops work.
My question: I don't know if sometimes the side effects of the drugs can compensate for the changes in the way I feel, and I also wonder if the medicine could be discontinued if I don't get another atack.
I feel that the medication has always the good side and the other side that sometimes the doctors don't tell you. after reading the summary of the Amiodarone it makes me wonder if I should discontinue it. thanks
Seems like evrything in this business is very experimental; all you can do is try and try and try...
I had ablation about 5 years ago when I was 14 at the University of Pennsylvania. I was having episodes about once a week and my heart would beat faster each time. Eventually when they finally decided it would be best for me to go through with the procedure was when my heart rate hit 279 while playing volleyball in gym class. They then took me to the U of Penn where I was put in the hands of 2 of the best electrocardiologists in the country. They did the procedure and it took about 6 hours to complete. Mine was very difficult because it was right near one of my major pathways. The only scary thing about the whole procedure is when they have to speed up your heart in order to find the problem. I was awake though for the entire procedure. I am now 19 and havent had an episode since the procedure. Just last week though my heart started acting funny but I think it might be anxiety or stress related. My heart skips sometimes almost like it misses a beat but then it makes up for it with the next beat. It never seems to happen when I am keeping busy or excercising it only happens when I am sitting on the couch or lying down in bed. Does anyone think I should be concerned or does it sound like nothing. I am now in SC going to college and the medical care is not very good here so I am very reluctant to go get it checked out. If anyone has any suggestions it would be much appreciated.
Thanks Zac