Atrial Fibrillation

[Ellerby83]

Has anyone got this? I was diagnosed a few weeks ago. Am 51 and no other health issues. I had a cardiac scan which was normal and had a follow up appt with cardiologist. (Quite surprised at the speed of all the appointments). Cardiologist told me to stop taking the beta blockers and blood thinners as my stroke risk was low. I did have another AF episode a week later.

how was your original episode captured? How do you know you had it a week later? Apple Watch? Can you clarify what a cardiac scan is? A CT scan of your coronary arteries or and echocardiogram?

I had two ECGs at the hospital, the later scan was an echocardigram. I dont know later episode was definitely AF as I was still trying to decide whether buy an apple watch or a kardia mobile but I had strong palpitations and could feel my heart beating irregularly for a few hours.

those are valid definitive tests and luckily you had it “caught” on ekg. Some patients feel afib and some don’t it’s so highly variable. But palpitations and irregular feeling beats could and likely would indicate afib. Apple
watch or similar device are accurate in my clinical experience. My concern is how does the cardiologist know your stroke risk is low? A heart monitor worn for 2 weeks or longer would determine the “burden of afib”. This would be an objective determinant of your stroke risk based on the frequency of afib (burden) For me at 51 I would take blood thinner to make my stroke risk nearly zero. This would depend (for you) on other medical history risk stratification. Going “in and out of afib” is a stroke risk itself. Then of course genetics weight diabetes co morbidities. I would ask about a monitor. Can you “chat” your cardiologist via computer versus a return appointment and inquire if you would benefit from heart monitor to “quantify the burden of afib”.

She said my stroke risk was low as my blood pressure and bmi are normal. I dont drink or smoke and have no co morbidities, no family history of heart problems or strokes. At that point it had only happened once. I can phone the cardiology dept direct if I have any issues. I wasn't sure whether to phone them after the 2nd af but thought I would see whether there was any more episodes and I could capture it on the kardiamobile I now have. She did prescribe pill in a pocket Flecainide and Bisoprolol to take if I go into AF

Sorry to hijack your thead but what's the difference between AF and palpitations?

Palpitation is the sensation felt by the patient of an abnormal heart rate or rhythm - rapid, fluttering, irregular, pounding, etc.
Atrial fibrillation is a specific type of abnormal heart rhythm.

Op that does sound like a reasonable plan of care. I do still recommend a monitor. An apple watch or other device is worth the investment. If your rate or pulse is high that is a reason to go to a&e as afib with rapid response is a medical emergency. As to other poster…afib is not always symptomatic or often an early presenting symptom is shortness of breath. Palpitations are often the result of irregular beats called PVC Premature ventricular contractions and tend to be felt at rest. Afib can present as fluttering feeling but that’s not typical. PVC do not carry a stroke risk in and of themselves.

As to other poster…afib is not always symptomatic or often an early presenting symptom is shortness of breath. Palpitations are often the result of irregular beats called PVC Premature ventricular contractions and tend to be felt at rest. Afib can present as fluttering feeling but that’s not typical. PVC do not carry a stroke risk in and of themselves.

@Lavenderandbrown
Yes, as I said, palpitation is a sensation and atrial fibrillation is a type of arrhythmia.

Thanks for your advice. I'm trying not to worry about it too much. I agree it was lucky that it was caught on the ecg and I got a diagnosis quickly.

I have Afib. Diagnosed at age 63 while in hospital for something else! They always find something..... Anyway I was put on blood thinners (Eliquis) and bisoprolol 5mg. I had no symptoms apart from the odd flutter when stressed which I put down to that, as you do.

So then I had a gastric bleed due to a perforated ulcer since I had (symptomless again) H Pylori. Taken off the blood thinners immediately and given blood transfusions and later iron infusion. I was 64 then. No blood thinners still, but I was reviewed at 64 and 8 months and since blood thinners were out for me, I was fast tracked for a Watchman device. This helps stop clots in Afib rather than taking anti coagulants. Cardiologist was determined that I get the device before I turned 65, which is the danger zone for stroke apparently!

Anyway so far so good. I just take Bisoprolol now and hope for the best. Sounds to me that your stroke risk is low but I'd personally like to get more reassurance on that point.

I'm a member of Atrial Fibrillation Support Group on Facebook, they are a very helpful community and lots of information there, all ages from young to older like myself. You might like to check it out. There's no information better than from others with the same diagnosis! Best of luck to you and hope all goes well.

@hastalava thanks for your reply I'm glad your watchman device is working well for you. Will have a look at the facebook site.

@Ellerby83 how are you getting on now OP?

Crikey I’m 65 next year never heard about that being the danger zone for a stroke!

I’ve been on a blood thinner for decades for AF.

Thanks for asking @Gertrudella I bought a kardiamobile so I could do ecgs at home and all was fine even went on holiday doing hill walking in hot weather. A few hours after the flight home had another episode worse than the second one resting hb 140 to 180. Felt really shit. Went to a & e the next morning as the pill in pocket tablets hadn't worked. 5 mins before saw the doctor I realised I had gone back into normal sinus rhythm. Dr was lovely and said in future I should come in a few hours after the pills haven't worked. On the plus side I realised that dehydration is a trigger for me as had hardly drunk anything when travelling home. So am now drinking lots more water.

Age is part of the ChadVasc score in Afib. A score of 2 or more means increased risk. I had a score of 2 at diagnosis of Afib (age 63) so I was given anticoagulants. Since I couldn't take them after the bleed, the consultant was determined that I had the Watchman before I turned 65 which would have made my score 3 and that - brought me into the danger zone!

CHA₂DS₂-VASc Score for Atrial Fibrillation Stroke Risk (mdcalc.com)

Just being 65 is not a stroke risk, but is part of the risk score if you have been diagnosed with Atrial Fibrillation. Maybe your score was such that anticoagulation was needed when younger than 65. Hope you continue to do OK.

Op do you snore at all? Afib can be a commonly linked to sleep apnea.

No I don't snore. DH has never said I do anyway.