afib

[scag]

hi i have a question,first of i would personally like to thank all the docotors that contribute their time and knowledge to this site,i am a 30 year old male i was in the er may of 2003 for an episode of afib,my heart rate at the time was 180,i saw a cardiologist in the er after all my tests were done,i had an echo,ecg,al bloodwork etc,all came out normal,the cardiologist said it looked like an episode of lone afib,the only thing on the echo was slight left atrial enlargment,but the said that almost always a finding,because im a big guy to 6 feet 290 pounds,my question is is the enlargment anything to be concerned with dow the road?and also i have not had any trouble with skipped beats or anything since then,once in a while i will have a pac or palp but thats it?,i am on 25 mill of atenolol since may is it necassary to continue this medication?after 8 months can i assume i wont have anymore episodes of afib?
thanks scag

[CCF-M.D.-RCJ]

scag,

Thanks for the post, and you are certainly welcome.

Q1:"is the enlargment anything to be concerned with dow the road?"

Given your size, the enlargement may very well be normal for you.  I'm sure you agree that Shaq's size 18 feet are enlarged, but for him they are just right.  You didn't give the dimensions of the LA, but your doctor seemed to indicate that he/she thought the enlaregment was proportional to your body size.

However, overweight people often develop heart enlargement and high blood pressure.  You didn't mention whether or not you have high blood pressure, but if you do, then the LA enlargement may be from the high blood pressure, in which case it indicates that you are beginning to suffer ill effects from the high blood pressure, and a lifestyle change is in order.


Q2:"i am on 25 mill of atenolol since may is it necassary to continue this medication?after 8 months can i assume i wont have anymore episodes of afib?"

Talk to your doctor about stopping the medication, but No, you cannot assume that the afib will not occur.  To be perfectly honest, if your weight continues to be elevated, you are likely to have more and more bouts with the afib as you age.

Hope that helps.

[michi]

hi hank,

i have a question for you, you seem to know a lot and i just had a scary expierience.
usally i get heart flutter for a second once a week. today it stayed for about 5 sec. that scared me a lot because a felt a litte bit dizzy afterwards. i stopped the flutter like feeling by coughing and my heartbeat went right back to normal. about 2 min. later it started again I started coughing right away to stop it.do you know by any chance if that was atrial flutter or svt? i know its only a short period of time but when it happens it feels like forever.
thank you very much.
if my writing is a little bit off, i am german and not perfect yet in the english grammar ...

[bigmick]

Michi,

I also get the same 2-5 secong runs of irregular fluttering heartbeat - usually one or two of them most days. They are highly variable as regards how they 'feel' - some are slow and regular but heavy, some are fast and irregular and light, and some (the faster irregular ones) do indeed occasionally make me a bit dizzy (and slightly sweaty of brow for a minute or two afterwards). As you can guess, these have never occurred whilst I have been hooked-up to a heart monitor. I have also for 17 yrs had single ectopic heartbeats (PACs and PVCs) on and off. I have had 6 episodes of lone (night-time) atrial fibrillation during the last 7 yrs. I am a generally fit and healthy 6'4", 230 lbs, and ECG, stress-test, and echo all check out A-OK. [I did have a HIGHLY traumatic (violent and abusive) childhood at the hands of a demented alchoholic adoptive father, for which I am currently in therapy - it's a long road back as regards bringing those memories-locked-in-tissue OUT.......] I have for the last 8 years been diagnosed with, and treated for, quite severe Generalised Anxiety Disorder (GAD) and I have, I will freely admit, become a little obsessed with my cardiac health - a personal foible not helped by my to-PhD-level education (AKA over-educated and over-active brain)! I am VERY aware of my own heartbeat, and am therefore also MEGA-aware of when it goes a little out of sync. I have read many times that most healthy middle-aged adults will, if monitored for 24 hrs, show at least some PACs and/or PVCs, with many of them furthermore showing short bursts of more complex arrythmia. The vast majority of these individuals are simply unaware of, and commensurately unconcerned with, their occasional ectopy and/or arrythmia.

Hankstar,

I - along with Michi - would appreciate any input you are able to offer as regards the short flutters which cause a little dizziness and a bit of a brow-sweat. I am unsure as to whether thay are AF or an irregular run of PACs/PVCs. The most uncomfortable such flutters I have experienced have felt fast, irregular, up in my throat, have made my head swim a little, and have terminated with a compensatory pause and a heavy THUMP! I feel that I might bring on the sweaty brow (and maybe the dizziness to some degree) by starting to panic a little once the run goes beyond a couple of seconds up to 5 or 6 seconds or so.

Cheers,

BM

[bigmick]

Thanks for the courteous, prompt, and helpful reply. I too have speculated that such short runs of 'the flutters' are one or other of the arrythmias to which you refer.

I would speculate that the lightheadedness which can occur when such a flutter lasts for over 2 seconds could, I feel, sometimes be a little more than an effect of anxiety alone. It is possible (likely) that one's cerebral bloodflow is momentarily heamodynamically compromised, with a little dizziness/thick-headedness/hot-headedness ensuing as a result. One feels this and then compounds it with a mini-panic of anxiety.

BM

[arthur]

As one who has had lone Afib, has been successfully ablated, and still has a few skips...I know for a fact that anxiety is a terribly difficult problem to overcome.  Don't sell it short, and don't think that because you know you're doing it, it has no real effect.  The reality is that once anxiety becomes part of your psyche in dealing with skips/arrhythmias, you are on the road to an obsessive compulsive disorder.  The cycle is real simple...you get the skip, you feel puzzled, slightly worried, you check your pulse, you feel that this may need some attention, you worry about it's significance...of course, your anxiety level goes up, and your nervous system is cranked up...this leads to an altered nervous system state which in turn leads to a higher propensity of skips and arrythymias...the next thing you know, your begin to feel every skip, and you definitely can feel your pulse without even trying.  It's a cycle and a spiral.  Once you settle down, and the nervous system gets wound down, things return to "normal"...however, you just went through one cycle of "training" wherein your nervous system will eventually know that when you detect a skip, it knows to crank things up, even though you think you are being rational about it all.  In my case the cycle was broken by two approaches...(1) I stopped checking my pulse (which had a major effect), and (2) I stopped caring about random skips.  Both steps are tough, with (1) being a little bit easier than (2).

I bring this up because I have been cured of the afib and I am totally not concerned about anything else that pops up.
This I define as a total cure.  Assuming you have everything else physically normal, there is nothing to worry about.  Of course, my saying it doesn't mean squat.  Your behaviour is what YOU need to alter.

-Arthur

[michi]

well,

thank you. i had all the works with my heart even a catheter which i have since a tickle in my throat and they tell me its not related but that tickle came up heavily yesterday and the flutter startet. they say my heart is normal i am on the lower side of EF and my left ventricle is aswell on the lower side what they told me would be better than enlarged. when those flutters came and i was on the event monitor i were able to catch one and the EP could not really identify if it was afib or svt. they have seen pvcs and pacs. so i decided to change my doctor to get a second opinion.
another question i dont know if you can help there. but when i had the catheter done they damaged a nerve in my leg. i got told it will heal within about 2 month. but its been 5 month now and it is not getting really better. it was better when i was on bedrest (i had been pregnant for 12 weeks and lost the baby) i hardly had any problems but moving arround and work again (gymnastics coach) made it worse. any suggestions?

thanks

[bigmick]

Michi,

I'm most sad and sorry to learn that you lost your baby - it might not help much if at all..... but here's a BIG long hug from BigMick over here in northeast England.

I can't help with your groin injury problem, but I'm sure others here will step in with advice and reassurance for you.

Mike

[woaini]

Hi there.

My heart has been also going through these phases since a few years now. I am now 43 and the first time I recall having this feeling is when I was about 14, I would walk and suddenly I felt this strange thing in my chest, like my heart was about to give up on me. I check with the nurse at school and she told me that my heart was normal. The problem did go away after a while and didn't feel it for about 20 years. Now, I have them again almost every day, sometimes I'm very worried about it but I realise that I must perhaps live for the rest of my life with it. Many people can't relate to this ffeling because they never had them but I can.
Courage is what we need to overcome these difficulties.
Dany.