A Fib

[jeanette1952]

I had my first A Fib episode last Friday.  Went to the ER and they did EKG and found me to be in A Fib.  Stayed in A Fib for 10 hours...was given IV meds including cardizem.  My troponin levels increased as three blood tests were done.  They did not increase dramatically but cardiologist thought I had a mild heart attack.  He also said there were small "changes" on EKG.  I do not know what that meant.  A heart cath was done which was normal and an echo was done also with an EF of 56.6%. I guess the echo was alright.  He said my heart was "good."  My anxiety level is always off the wall and it seems he attributed the episode to anxiety.  Note: I do have hypertension but it is controlled well with meds and exercise.  He said to take an 325 mg aspirin daily with my metoprolol.

From everything I understand once you have had a bout with A Fib you are certain to have more.  How much damage is done with each episode?   With my anxiety level as high as it is, I want to have an ablation to rid myself of this.  Is that a viable choice?  I cannot live each day waiting for the next episode.  Please advise.    

[jeanette1952]

Thanks again to all who answered y inquiry.  It has been very helpful.  I see the cardiologist on 6/18/14.  Have a great day all of you!  

[theresamomof3]

My husband who is in good physical shape was diagnosed with both A Fib and A Flutter last February.  From what the cardiologist has told us is that it doesn't do any damage to the heart, just makes the rhythm "go funky" as everyone tells us and we have gotten onto figuring out.  Sometimes the ablation is slow in working or doesn't work at all because my sister in law also has been diagnosed with afib and had the ablation done and has had to be converted at least once after the ablation because she didn't come out of it.  I would definitely make sure you get a cardiologist and are seen by them.

[jeanette1952]

I forgot to mention that I am a 62 year old female.  I walk every day and my cholesterol was: Total - 143; HDL -73; Triglycerides - 64 and glucose - 93.

I am scared to death of congestive heart failure.  My father had this...not because of A Fib though.  I just thought an ablation would get rid of this and I could go on without more anxiety and stress.  I want to thank those who responded to my inquiry.  

[Artaud]

You seem to be in pretty good standing, an Ejection Fraction of 56.6% is fine.

"The left ventricle is the heart's main pumping chamber, so ejection fraction is usually measured only in the left ventricle (LV). An LV ejection fraction of 55 percent or higher is considered normal. An LV ejection fraction of 50 percent or lower is considered reduced. Experts vary in their opinion about an ejection fraction between 50 and 55 percent, and some would consider this a "borderline" range."

Other sites I visited said that anything over 50% is normal, as had one cardiologist told me (none of the others said anything on the issue, I just remember him discussing the subject). You had a normal heart cath, you should be rejoicing. The Echo was apparently normal as well. Don't be put off by the "good" remark. Good is better than "there's a problem".

The heart has 4 chambers, two on top (Atria) and two on the bottom (Ventricles). They generally describe the heart as right and left sides. The blood returning from the body to the heart enters the Right Atrium, but it's coming back so fast that it mostly fills the Right Ventricle as well. The heart beat occurs, the Atria contract, the Right Atrium forces what blood that remains in it into the Right Ventricle, the Ventricles contract, and the blood from the Right Ventricle gets pumped to the lungs. Coming back from the lungs it enters the Left Atrium, also filling the Left Ventricle, another heart beat occurs, the Atria contract, the Left Atrium forcing the blood remaining in it into the Left Ventricle, the Ventricles contract, and the blood from the Left Ventricle gets pumped to the body. This is going on simultaneously, blood from the body to the lungs and from the lungs to the body.

It's that extra blood that gets cleared from the Atria that's the problem in Afib. Since, in Afib, the Atria are not beating rhythmically, there is a chance in the nooks and crannies of the Atria for clots to occur. If they'd happen in the Right Atrium, they'd be pumped to the lungs, in the Left Atrium, to the body. This is why doctors prescribe Aspirin or other blood thinners to prevent clots from occurring. Also, people may feel fatigued and tired. This may be due to the disturbance in the Ventricular Rhythm, since the Ventricles usually respond to a discharge from the heart's natural pacemaker in the Atria. With the Atria in fibrillation, the Ventricles may not beat consistently enough to assure a sufficient blood flow for all exertion levels, resulting in fatigue.

As far as I read, no damage to the heart occurs from Afib, just the disruption of blood flow dynamics when the heart is actually in Afib.

Ablation often corrects the problem, but some ablation procedures will not be successful, possibly resulting in additional ablations. Some people develop other rhythm issues after an ablation, sometimes only temporarily (for several months after the ablation), sometimes long term. These are things you need to discuss with your doctor.

[Bromley]

OK.  There are a couple of indicators on ekg that can be markers for ischemia (i.e. blockage). For example, you can have "ST depression" which is where the ST segment is reduced from its normal height on the ecg. Not all ST depression is considered diagnostic of ischemia however. You need a minimum amount of it in order for it to be considered significant.

If I understand correctly, I dont think afib actually damages a heart. This is just a bad rhythm that makes you feel lousy. It is also associated with other problems, namely increased risk of stroke, which is why they are inclined to give you blood thinners if you have afib.

Ablations are possible, but are not that straight forward in terms of outcome. You used to hear a lot about Pulmonary Vein Isolations which were at one time described t be the best way to deal with the problem, but the industry seems to have fallen out of love with these, at least somewhat.  There are some definite risks with a PVI, from what I read pulmonary vein stenosis one main concern.

Several people here have afib and a fair amount of knowledge.  I hope someone can give you a perspective. Several people are able to control their abnormal heart rhythm and lead normal lives with their afib.