Levels of Afib

[kevtt]

My afib episodes have decreased in intensity (but not frequency)- sometimes I can barely notice I am in it and need to feel my pulse to detect the irregular beats to make sure. I used to have heart thumping,high pulse rates associated with each episode. based on your experience, does this pattern of decreased intensity eventually lead to the cessation of afib entirely?

Can I assume this lower intensity also lowers my probability of having a stroke? I would like to get off of aspirin because of gastric worries down the road (even though I am taking the enteric coated ones).

And, if it takes 48 hours for a clot to form, why not take aspirin when afib occurs instead of taking it daily?

Thank you for being a wonderful resource.

Kevin T.

[Dominator7]

For what it is worth, about 10 years ago (I'm 53), I smoked for a few years and then I quit. After a few weeks it felt like my heart was skipping a beat sometimes. It felt very noticiable sometimes, but there was never any pain. As I monitored my heart it seemed to stop and then there were 2 quick beats and then a normal rhythm until it skipped a beat again. I went to an emergency room and the doctor their monitored my heart and told me it was PVC's. He explained that sometimes my heart would take a little longer to fill before it pumped and I had 2 fast beats, and it wasn't harmful unless it became too intense. It seemed that after eating the PVC's increased. Whenever I went to my doctor it was beating fairly regular, so he gave me a Holter monitor to wear. When he examined the data from the monitor he said he could see the PVC's and he thought it was happening too much. Shortly after that visit I went back to smoking and the PVC's stopped. What was more expensive the drugs or the cigarettes?
I eventually quit smoking after my heart went into AFIB, but that I'll write about at another time.

[DQ]

It's interesting to hear that some people can't feel their heart beat irregularly.  I have had PAC's for years and for the last year I have Afib once in awhile.  I know exactly when I'm in Afib, and I can feel the irregular beats.  Part of that is due to the fact my heart beats are quite strong since I have been a long distance runner for many years.

I have seen two cardiologists.  One prescribed coumadin, and another said aspirin is OK.  He said aspirin is only OK because I know exactly when I am in AFIB, and I am 47.  If I was older he would keep me on coumadin.  But I always have coumadin around, because if I get an attack that lasts longer than a few minutes I take it.  The first 48 hours is the most critical time to get the blood thin so it doesn't clot too easily.

I am also on rythmol.  I tolerate Rythmol very well, and as my doctor said it keeps other irritation points from developing and it converts me if I am in AFIB.  That's not true for everyone.  Everyone reacts differently to drugs.

But I have found for me the key to a lack of AFIB attacks is stress management.  If I get too upset or irritated, I can gaurantee I will get an AFIB attack in the evening or morning.  If I run, maintain my cool, and take life as it comes, I can go weeks without an AFIB episode.

But everybody has different triggers.  But whatever you do TAKE ASPIRIN OR COUMADIN!   The key danger is stroke, and both of these are great (and cheap) preventative measures that are far less risky than the alternative.

[JawsLAS]

It is very interesting to read of the symptoms that go along with a-fib. While it has been a part of my life through my father for quite awhile now, I was unaware of how many things are associated with it. My father is not a very vocal person, and he basically refuses to tell us what he is feeling, so hearing about it, makes me understand what he may be feeling now. He has recently been having a lot of nose bleeds, and I have been basically chalking them up to unstable coumiden levels, like maybe his blood is too thin, but is that something that can happen with the use of coumiden? Also, can the inconsistancy of the heart beats cause the protime/coumiden levels to go up and down? I mean I think it is absurd that he can be at a 3.9 one week, and 1.2 the very next. I truly apreciate this forum, it has really given me a realese to deal with this, becasue I realise that while I am not personally going through it, it is very disturbing to watch someone else go through it.

[wingtip]

The only migranes I had associated with my a-fib is when I was cardioverted.  It was almost a relief to get out of sinus rythem because of the headaches.  The tingling sensations have always been attributed to nerves, and only occured frequently when I first stared my coumiden.  I think it was more related to stress because I though I was " sick" as opposed to having a condition that you had to watch.

[travis911]

Reading about all this afib has got me worried. I am a 29 year old male at ideal weight. I started a new exersise program last week which starts out with a few miles a day of jogging. The first 2 days of jogging went well with no problems. The third day or running i decided to jog an extra mile making it 3. While I was jogging I noticed my heart was begginig to skip beats. This didn't concern me much because i have seen a physician about this many times in the past in which he gave me ekg's and ruled out my complaints as panic attacks (which I don't get anymore). After the jog was over and i had cooled down, I noticed that my vision became distorted. I couldn't seem to make out even simple objects. I laid down for a few minutes and slowly my vision improved leaving me a very intense migrane.
Also, I too hear my heartbeat throughout the day noticing many skips at times. Can anyopne help me in this matter?

[Linda123]

Dear Travis
Sounds to me like your vision distortion, etc. was down to a migraine attack - that's generally what happens, it happened to me a couple of times years ago.  First I got zig-zag lines infront of my eyes for a few minutes and couldn't see properly, then I threw up, and then I got awful pain down one side of my head.  I understand this was classic migraine.
Best Wishes
Linda123  

[Linda123]

How does one know if they are having afib, or just having palpitations?  What's the difference?  I've never managed to catch a sustained irregular episode of mine on tape, all that I've managed to catch are extra beats coming from the right ventricle and one 3 beat v-tach. The longest time I ever had of a sustained irregular episode, and it was quite violent, was for about half an hour which left me breathless and with pins and needles in my hands.  It makes me wonder when I read of people who are in afib and don't know it (I'm jealous....) as I feel every little (and big) palpitation of mine, it makes me think that maybe I can't have afib??  Is it possible to have a sustained attack of pvcs?
Linda123

[wingtip]

My EP and GP feel that if the condition is not disabling, the cure is worse than the a-fib.  By reading things on ths bulliten board for three years, there seems to be  lot of people who have ablations who aren't cured or get a different problems.

[JawsLAS]

Thank you for responing wingtip:) Have any of you heard anything good/bad/indifferent about ablation therapy? I have read about it on the internet, and I thought it would be helpfull to get some outside input. Is it maybe a good follow up to a failed cardioversion?

[wingtip]

I went through the same things after the cardioversions failed.  But A-fib isn't fatal, it just can be a contirbuting factor for strokes if you don't take coumadin.  I imagine he'll learn to live with it, its just that when you in your 30's and 40s, its easy ti think of this as a heart problem akin to blockeges and the like, and it takes a while to get used to the idea that its not in the same league.

I also had bad viral infections prior to the onset, but it runs in my family, so who knows.

[JawsLAS]

My Father has been in afib for 8 months now, but he is only 45 years old. He doesnt have High BP, has never had a heart attack, Has never had heart surgery, and his arteries are clean. The doctors say it was caused by a virus. Has that happened to anyone else? He has gone through the cardioversion, and that did not help, he is currently taken all kinds of medication including, Toprol, digitec, and coumiden. But that is not the problem, the problem is the depression and mood swings that have gone on during his illness, is this normal? Has anyone else experienced this? Is there anything else we can ask the doctors to do, I mean its kind of like they are dragging their feet on this, after the failure of the cardioversion, its like they sent my dad home to die or something. Anything anyone has to say wouyld be helpfull, thank you!

[wingtip]

I am on coumadin, 6gm a day.  

As far as A-fib being common in seniors, I read this on most of the cardiac web sites and was given that information from my GP and EP.  The GP and EP state that unless I have symptems that are causing my life style to suffer, any cure is worse than the sickness.  As I have never had any problems or complaints, the doctors say wait.  If your still in the flutter stage and the doctors say you have a healthy heart, cut bacl on the caffiene, learn to relax and avoid alcohal most of the time.  To worry about heart flutters becomes a never  ending circle where the worry causes the heart flutters.

[SRBKING]

I don't know if AFIB is always associated with a high bpm...Mine is seldom that high, but what I experience is the flutter.  Usually around 82bpm.  They told me that my rhythm is indeed sinus rhythm, yet my arrhythmia occurs in small intervals that last about 2-5 seconds, then go away and come back about 30 minutes later.  It is very hard to catch on EKG due to its timing.  Basically, Ive been told that it doesnt really exist, and that I am going through a lot of anxiety.  Then why do I still feel the extra beat every now and then??

[kevtt]

What do you do for stroke prevention?

Where did you hear that being in afib constantly is normal for seniors?

What's ccb and how does that differ from betablockers?

Thanks.

[wingtip]

Except for the couple of days after each of my two cardioversions, my heart has been in constant A-fib.  The doctors put me on a beta blocker to keep the rate down(I never knew it was hitting the 200 bpm level until a holter test).  The beta blocker seemed to cause fatigue so I was put on a CCB, which let me start to jog, then run, then run for long distances.  I never got fast but I ran four marathons last year while in A-fib.  At that point the doctors had to greatly reduce the medications because my heart had started to beat to slowly.  Constant A-fib is quite normal for seniors, and they learn to ignore the funny rythem, so for the most part, I hardly ever notice the crazy beat.  I have to assume my heart is in better shape because I have more energy and the EF hasn't deteriorated on the echos.

[Maria77]

Just wanted to post a comment regarding aspirin.

I wish people weren't so reluctant to take an aspirin a day.  I just wanted to say that I took 5,200 mgs. of coated aspirin a day for ten years, and never had any problems with it.  The reason I was taking it was for rheumatoid arthritis.  And yes, I know that is a very large dosage, but for me, it worked.  I was taking the enteric coated Entrophen 10 (which is 650 mg.), and I was taking 8 of them a day.  

Just hoping that those of you that are reluctant to take aspirin for their heart (isn't it only 81 to 325 mg?) will reconsider.

[Crow]

I know I would certainly like to know since I had 4 surgeries & spent 76 days in hospital due to blood clot which was caused by a-fib.  I stayed in a-fib for 6 months after got pacemaker and was cardioverted, but still have it, but a lot less.  I also take coumadin.

[kevtt]

What do you mean cardioversion didn't work? So you always in irregular heart rhythm???

And what do you do for a "healthy" heart? And where do you learn about this? Thanks.

[wingtip]

When I was in my 20's, The episodes were very strong when they hit.  In my thirties, I never noticed it much, so you can imagine my surprise when the doctor asked me how long my heart had been acting up.  I told him it wasn't.  He found that I was in A-fib all of the time and that I had just gotten used to it.  By that time it was too late for the cardioversion to work.  

That being said, My fitness level has never been better because the problem caused me to work on my heart health.  My father has been in A-fib for years and doesn't have a problem with heavy work either.

[CCF-M.D.-RCJ]

Kevin,

Thanks for the post.

We don't know why some people develop "lower intensity" afib.  I think several reasons are at play.  First, the medicines (such as beta and calcium channel blockers) used to treat the afib may mask the symptoms.  Second, people may have two types of episodes: those that they feel and those that they don't.  Third, people may simply lose the sensation due to the aging process or an accomodation phenomenon.

A decreased pattern of intensity does not change the prognosis of afib or the probability of its recurrence and does not lower the expected complication rate.  Specifically, the stroke rate is not lowered.

The reason not to take aspirin on an "as needed" basis is precisely what you have described here: people often don't know when they are in afib.

Hope that helps.