Cardiologist appointment AF

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Hi, I was diagnosed with AF last april. I am now thankfully going to see a cardiologist in a few weeks, my first time as I have always been seen by a gp. I have so many questions that I want to ask them. But I would really appreciate any help with questions you may feel would be of help to me please as I really want to use this appointment to its fullest potential.

?I am 43, Male 6ft & 15st don't class myself as over weight but would like to loose a few pounds. Up until last yr I was very active healthy & fit. Post AF diagnosis I lost my confidence, my energy & any motivation whatsoever. I started to get anxiety attacks that I am currently getting under control now, the odd one now & then but much better.

?Originally on bisoloprolol but due to this not agreeing with me at all, (extreme fatique, dizziness, sense of skin feeling sunburned) was changed to Sotalol 40mg twice per day, which is a huge improvement on the previous medication. I also take Rivaroxaban each day for my blood thinner, & losartan potassium for high blood pressure.

?Ive had high blood pressure for a few years, started as medicated for couple of years but then gp took me off them for a year as said I didn't need to be on them then? then monitored on/off for 12mths as on the border as my gp would say. But then with my anxiety kicking in my blood pressure stayed around 155/110 going much higher with an anxiety attack. Now my blood pressure medicated is on average 127/85.

?My resting heart rate is between 50-54, sometimes lower. Before my AF, it was still lower than ideal at about 58.

?Although much better, I still get AF at times (can go weeks without AF) usually lasts for about half hour then goes. The past wk & half ago I was in AF each day for 7 days in a row, shortest not long at all, the longest almost 8hrs, I had the funeral of my aunt so I put this down to this emotional time but isn't this what the medication is for, this was my worst time with AF, as usually it either just goes on its own or if I do breathing techniques to revert back to normal.

?I also have obvious links to AF & the vagal nerve which I have self taught what not to eat, but trying to explain this to my gp is almost impossible as keeps telling me cant cause AF, very frustrating as I know & read from others who also have the same.

?Ive been light headed on/ff for about 12mths, can go couple weeks with nothing then lightheaded for days at a time, my gp not concerned with this though. At first I thought this maybe related to my heart rate but I haven't found a connection as yet, as when I check my rate is still normal, for me.

?I read that AF cant be cured, but then read people who have ablations, cardioversions who say it worked, is this not classed as cured? I appreciate as with anything in life conditions/diseases can come back whether it be due to illness,age, lifestyle etc... but the positive in me sees this as cured, for now atleast rather than think its just a waiting game till the next time.

?Are there higher success rates for any procedure in particular or is it purely on a personal level.

?I see myself as still young,& I am so desperate to get myself back to the old me who was very confident, outgoing with hopes & dreams for me & my family.

?Thankyou for taking the time to read this, your help means a lot to me, thankyou.

?

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  • Posted

    I have had two ablations, neither of which have stopped the AFib. 15 weeks since my second one and having more frequent attacks ( almost daily) and now getting ectopic beats too which I never had before.

    ablations can work for 90% if you are lucky.  Flecanide I take 300 mg but it does not seem to help.  You sound early down the path so hope you get sorted. I was more than happy to have the ablations rather than put up with afib, but if you go down that route be aware that a cure is not guaranteed.

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    • Posted

      Thankyou for your reply, I'm assuming a lot comes down to personal situations & health & possibly some luck as to whether ablations are successful, such a frustrating condition. I am hoping that as I'm still relatively young this could be a positive for me, I'm willing to try almost anything than put up with the AF and its side effects. Many thanks.

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  • Posted

    Firstly,anxiety is the main trigger for AF. There are lots of palpitations which are not AF. What tests have you had? Until the cardiologist has diagnosed you accurately you should not assume anything.

    AF can be controlled by the right meds and does not kill you so accept it and live your life to the full as you were before. It is very common and there are far worse diseases to have.

    good luck but stop dwelling on it, worst thing you can do.

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    • Posted

      Hi Sarah, I originally went to A&E with chest pains but after having numerous tests the doctors confirmed it wasn't my heart & in fact it was my stomach. I have suffered with chronic GERD for 12yrs & at times the pain is just incredible.

      ?But I was given a stress test at a later date, please forgive my spelling if incorrect. A dubotimine stress test, adrenaline via injection given every three minutes until max heart rate reached. By the time the date came for this test I was having full blown anxiety attacks due to my pain & although everyone kept saying it was my stomach I thought they were mis-diagnosing me & nothing could reason with me. 

      ?I reached maximum no problem but when they injected a beta blocker to slow the heart rate back down, for a moment I thought my heart stopped as went from maximum to felt like nothing, at this point they said I had a four second period of increased heart rate. At the time they said id probably take my anxiety medication on a more frequent basis.Then five weeks later when my gp received results said I got AF need certain meds & got to go on blood thinners, didn't expect that at all as seemed more a relaxed situation at the hospital.

      ?I appreciate that maybe with right medication AF can be controlled, my biggest fear is that as I am still rather young & every time I see a different gp they always say, your rather young to have AF (which I really wish they wouldn't say, doesn't help much with anxiety)I don't want this to lead to other heart conditions or to weaken the heart, so its the thought of this progressing onto other issues I have a real fear of to be honest aswel.

      ?I am very thankful of you getting in touch and helping, this site is just unbelievable the support information & advice is priceless.

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  • Posted

    Some of the rhythm control drugs like you've been on don't agree with many people and may account for some of the symptons you mention.

    How did they get you out of afib the first time? Once they got you out of afib, did they let you do a trial without any drugs? Many people have just one attack, or attack many years apart, and they don't take any drugs.

    How many of your afib attacks were confirmed by ekg? Sometimes we get benign palpitations after afib and/or we become more aware of our heart beat than before we had afib.

    If the rhythm drugs aren't agreeing with you, then again you might see how it goes without those drugs. If your afib episodes are few and far between, then no drugs may  be necessary.  Some people with more frequent episodes use a "pill in pocket" strategy where they only take a drug (flecainide) when they have an afib episode. After they convert, they go right off it.

    No reason at your age that you should have to either limit your activities or endure the side effects of rhythm drugs.

    Jim

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    • Posted

      Hi, before medication my AF was mainly at night, lying/leaning certain ways or waking up in the night feeling unwell. Id get up go for a walk or have a cup of tea & try sleep it off which worked. Also a lot of times was around my evening meal, I soon realised this and have since adapted my eating habits to almost reduce this fully at meal times.

      ?No gp or hospital visit got me out of afib, I came out of afib natuarally,& the length of each episode at first was relatively short. At the time it was more the, what on earth is going on than the feeling of being unwell. Not knowing what they was at the time, it was more the ectopic beats that concerned me as they were very powerful & made my chest ache, but as with the AF I quickly realised that this was happening every time I went too long without food. In my job theres no real dinner brakes as such so was a case of eat when can, so I could easily go 8-10hrs no food. Since diagnosed, I now prioritise my eating & drinking so only on the odd occasion I may get a short period of these beats.

      ?Ive had numerous ecg's over the past 12mths, none have ever picked up AF, only my lower heart rate.

      ?I genuinely feel that my AF did increase when I went onto the meds at the beginning, side effects put to aside, the actual AF had noticeably increased for I'm sure it was about 3mths, then approx. at about 6mths the med (bisoloprolol) had to be changed to sotalol, & so much better on this.

      ?I like the sound of the, Pill in the pocket strategy. I totally appreciate I maybe on my blood thinner for the long term, but I sort of see this as a safety barrier that others don't have,if I'm looking or thinking about this in the correct manner? But ill definitely be asking about the pill in the pocket.

       

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    • Posted

      Dean,

      Maybe I missed it somewhere but if your afib was never confirmed by an ekg, what makes you and the doctors think you have afib? Ectopic beats are mostly benign and while stressful pose no health risk or do they need to be treated with drugs. They can mimic afib but they are not afib. Only an ekg can really tell the difference. I wouldn't try "pill in the pocket" or any treatment for that matter until I was more certain if these episodes (or how many of these episodes) are really afib. Surprised your doctor didn't put you on a halter monitor where your heart rhythm is recorded for 24 hours or so to track and identify any heart abnormalities. There is also a portable device you can use anywhere to detect whether or not you have afib. It's called Kardia Mobile and it generates an ekg on demand in conjuction with your smart phone.

      Jim

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    • Posted

      Hi Jim, I did have a 24hr monitor but apart from the slower heart rate & ectopic beats no AF was recognised on the occasion wearing it. The only official time AF has been noted was during the stress test & that's it to be honest. Since then any occasion of AF has frustratingly not been seen by any other medical professional. 

      ?The occasions I know I'm in AF, I get symptoms like light headedness, head aches, severe fatigue & also at times feeling like my heart is pounding a lot harder & my chest will ache for a while. This is where ill check my pulse & find that my pulse is bouncing around all over the place with no one same rhythm.

      Ive never heard of the Kardia Mobile, are these easily bought over the internet as this sounds like it would be ideal for me.

      ?So far all my real information has been through this site with people like your good self giving help advice & support which I'm truly thankful for, but without sounding negative towards any gp's that I have seen its almost like, you have this so take that... with no real answers. This is why I'm so greatful to be actually be seeing a cardiologist who ive also been told is one of the best.

      ?Thankyou for your advice, I really appreciate it, 

      Dean.

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    • Posted

      Dean,

      I'm not a cardiologist, but I'd hate for you to be treated for something you may not even have, or "perhaps" had once during a stress test. And I say "perhaps" because signals can get mixed up. Hopefully, they saved the cardiogram tracing which you can take to another cardiologist. Which leads to the next issue, you should consider a second (or even third) consult on this from another cardiologist and probably an ep doctor as well.

      Without an ekg, hard to say definitetly whether those episodes you describe are afib or other types of irregular beats.

      The Kardia Mobile is manufactured by AliveCor.  Just google "Kardia Mobile" and go to the web site where you can purchase it online. It's also on Amazon, where I bought mine.  Kardia Mobile a very small device just a few inches long and very thin. It can fit in your shirt pocket. It works in conjunction with most smart phones, and generates an instant ekg that you can view on the screen, save, or email to your doctor. It also has a built in algorithm that instantly tells you if your're in afib or not. If the device isn't sure, you can still email the ekg tracing to your doctor. Or, for a fee, you can email the tracing to Kardia's cardiologists and get an opinion back within 24 hours, or even one hour if you use one of Kardia's techs. That's helpful if your doc isn't around or you just want a second opinion.

      Ultimately, the decision with your treatment should be made between you and your cardiologist, but the more accurate the information you bring your doctor, the more accurate your treatment.

      I also thought I was in afib, with pounding and irregular beats in my heart and throat, and I was pleasantly surprised when the first reading from my Kardia told me I was in normal rhythm. It was confirmed by a EP the next day. Big relief.

      They make a second, newer unit, called "Kardia Band". It's twice the price and you need an Apple Watch in order to use it. My suggestion is to just get the simpler, less expensive and more tested, Kardia Mobile, but both units have gotten good reviews.

      Jim

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    • Posted

      Hi Dean,

      I wrote you a detailed post about your condition and the Kardia Mobile but looks like it will be "in moderation" for a day or two. Not sure why.

      In summary, I think it's a perfect device for you. You can go to the manufacturer's web site, AliveCor, or order direct from Amazon. They make two units but my suggestion is to get the less expensive unit called "kardia mobile". The more expensive unit is "Kardia Band".

      Jim

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    • Posted

      Hi Dean,

      I've gotten two posts moderated already regarding Kardia Mobile so check your private messages in thirty minutes or so and I'll give you the information there.

      Jim

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  • Posted

    Hi Dean...have had afib for at least 5 years...vagus nerve is definitely involved...so is stress ....diet...straining in the bathroom...and gluten!!!It's hard to go gluten free after a life of normal ingestion of bread products...especially if you aren't diagnosed with Celiac..only with a sensitivity..I have had 1 silent stroke...but due to the fact that I had internal bleeding AVM in the small intestine...cannot take blood thinners other than aspirin...have taken a different approach to prevent and treat when symptoms arise...mine usually start with a gastric upset...I keep lactaid and 2 types of simethicone...chewable Gas x and the gel caps which dissolve in the intestine along with pepcid and pepcid complete chewable...this all helps to stop progression to tachycardia...the next step...

    Terrible belching..bloat and pain in solar plexus...then tachy...multiple pvcs....then full blown afib...I find I can control the progression by taking the above stomach meds in conjunction with a .5 or 1.0 lorazepam under the tongue and using controlled breathing techniques...I have never had to be shocked ..always converted except for the first time in emergency room when they used meds to do it...my primary Dr. Is an internist and I've been able to get him to think outside the box...I also have world class cardio and gastro Drs. You should shop around for some who can address your needs better as well. We are all a bit different in our triggers and in our solutions...I hope to have been of some help...I will continue to contribute to this incredible site. Fran

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    • Posted

      Hi fran, totally agree about the vagus nerve, I just wished some gp's would read sites like this to understand not everything is just text book.

      Ive suffered with terrible GERD for 12yrs, & know only too well the pain & misery with bloating, cramping excess wind etc... just had a PH manometry test for my acid so awaiting results.

      ?Ive always been quite healthy with diet, but since all this I have made it my priority to adapt a perfect for me diet. Like a lot of things in life, its trial & error until you find what works for you.

      ?I wish you the very best!

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  • Posted

    Start taking H & B magnesium tabs once a day it’s helped a lot of people inc me. 

    Just give it a try might sort things out. Good luck. 

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    • Posted

      Hi, thankyou ill certainly try anything to be honest. I have a chemist only few minutes away so ill pop there tonight, thankyou for getting in touch.
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