AF

I Live in Liverpool England and have just been for my yearly check, we don't seem to have the education or info on the PM the way people from across the pond do, so can you educate me a little please. The Tech said I have clusters of AF, what is this ?? is it the same as the PVC I get but from the atrium instead of the ventricle ?? I have the pacemaker for heart block, I thought a pacemaker regulated your rate ?? why am I getting these is my heart getting worse should I take more blockers ??

Moe

6 Comments

afib, etc

by Tracey_E - 2014-02-24 03:02:01

As knotguy said, afib is when the atrium quivers instead of beating. There are a few tricks to use the pm to pace out of it if it's really bad, but usually there isn't much the pm can do because it's the heart going on its own. All the pm can do is add beats, when the heart goes on its own the pm just watches. You may have had it all along if you aren't feeling it, but now you have the pm to record it. If they're short runs, not sustained and non-symptomatic, you can probably get by not doing anything. Meds would be the next step, though it sounds like you are already on a beta blocker?

AV block is when the signal doesn't get from the atria to the ventricles. If the atria beats and the ventricles don't follow, the pm kicks in and causes the ventricles to beat. The pm isn't actually regulating your rate. Your heart is setting the rate, the pm is just making sure the circuit is complete, that the atria and ventricles beat in sync. AV block has nothing to do with afib or pvc's.

PVC's are premature ventricular contractions, when the ventricle does a little half beat before the full beat. Most people have them. They are harmless and there isn't really anything to do about them. Like the afib, we have a computer recording lots of data. Sometimes it's tmi! We're getting overwhelmed with numbers and it starts to sound like lots of things are wrong when really it's just putting names to harmless things that happen to lots of people. If you feel good and your doc isn't worried, then don't worry!

A-fib common

by Theknotguy - 2014-02-24 03:02:32

The tech may be referring to repeated a-fib sessions that occur in groups. It's a natural progression of heart disease for some people. Like I tell some people, I can't help it my grandparents swam in the wrong gene pool.

A-fib is when the atrium quivers instead of beating normally. It can also be when the atrium doesn't beat in synch with the ventricle.

Based upon the severity it can be a minimal problem up to life threatening. But since you didn't say you got light headed or short of breath, you may have a mild case.

Some people can't tell they are in a-fib and have no outward symptoms. Others (like me) know they're in a-fib, get short of breath, light headed, dizzy, etc. It just depends upon how your body reacts.

Control for a-fib in the US is usually one of two kinds. Rhythm control or rate control.

Rhythm control is where they try to keep your heart in a rhythm. Rate control is where they let you go into a-fib but they keep the heart rate from running fast. There are a couple of PM's that have adjustments for a-fib although the jury is still out as to how effective the settings are.

For my Medtronics PM, I have APP. (Atrial Preference Pacing) It works for me, but Duke999 who posts on this forum it hasn't worked for him.

Depending upon the type of PM, you may, or may not have settings for a-fib. So if you get the kind of a-fib that makes the heart beat faster and faster, your PM will just sit there and observe. Unless, of course, your PM has an APP setting.

What can they do? As I said before, rate control, is one way to go, another is rhythm control. Under rate control they can give you medications (Cardizem, Metoprolol for example) to slow your heart then use the PM to keep your heart up to speed.

Ablation is one way to go to fix a-fib. However, it's invasive and, in some cases, only lasts for five years. So while it is an accepted "fix" for a-fib, it isn't always permanent.

Hopefully you only have mild cases of a-fib and they won't need to do any treatment. Hope my comments have helped.

Theknotguy

A-Fib

by Roys - 2014-02-24 05:02:00

Hi
google a-fib.com by Steve Ryan this website has all the info on a-fib.
Roy

Afib & atrial flutter

by golden_snitch - 2014-02-25 03:02:36

Hi!

NiceNicey, the others are right: The quivering is Afib, atrial flutter is typically conducted into the ventricles in a regular pattern with 2:1, 3:1 or 4:1 block. Therefore, with atrial flutter you usually end up with a regular and not that fast tachycardia, while with atrial fibrillation you have an irregular heart rate that can be in the normal range or too fast or too slow. However, both the flutter and the fibrillation can lead to clotting. So, depending on the frequency and length of the episodes, it's important to take a blood thinning medication. Rhythm or rate control is not always needed, if the patient is not symptomatic. But anticoagulation is important. Unfortunately, there are still a few old school cardios out there who prescribe aspirin for Afib patients, but this is definitely not according with the guidelines.

What was first, the pacer or the Afib? Well, before the pacer you didn't have a device that monitored your heart rhythm 24/7. So, what the pacemaker picks up as arrhythmias, is not necessarily always new, but just wasn't found before because the rhythm wasn't monitored so well.

Nevertheless, there is also clinical evidence that in some cases right ventricular pacing leads to an onset of atrial fibrillation. However, with Mobitz type 2 you are most likely not paced that much in the ventricle. Mobitz type 2 is intermittent, so you should need no permanent pacing.

Inga

Some A-fib Answers

by NiceNiecey - 2014-02-25 12:02:45

I've only had a PM since Christmas Eve but I've learned a lot in that amount of time. My heart is perfect except for the electrical conduction system and I, too, have heart block: Mobitz Type 2. I have a lead in the Right Atrium and one in the Right Ventricle. To my knowledge, I did NOT have A-Fib until AFTER I received the PM. My understanding is that A-Flutter is what our two friends described above as the quivering. A-Fib is rapid beating of the heart from the Atrium (I'm sorry if I just said this all wrong; remember, I'm learning). It is important to control A-Fib because it can lead to blood pooling in the heart's chambers and cause blood clots.

When my doc saw I was having episodes of A-Fib, he put me on a baby aspirin. Five days later, SURPRISE! I developed a DVT (blood clot). Since then, I have been taking a low-dose beta-blocker and a "real" blood thinner.

My device was interrogated again today and I have not had any further episodes of A-Fib. I have lots of PVCs but nobody cares about that.

Also, depending on the type of PM you have (single lead, double, triple with defibrillator, are there more?) all it does is monitor everything and keep your heart from dropping too low. I had a total misunderstanding of what a pacemaker did until I had one and was disappointed with how I felt. I have been "tweeked" 4 or 5 times since Christmas and I keep getting better, thank goodness.

Keep asking questions and seeking answers online. This has been the best place I've found.

All the best.

Advanced Primer on PVC's

by donr - 2014-03-02 08:03:15

MOE: Tracey gave them a name & a description of what they are. Justin case you cannot recognize one when it hits, I'm going to try.

For starters, A-Fib is nowhere near the same as PVC's. A-Fib is an arrhythmia that is FASTER than the normal HR. A PVC takes place at the same same rate as your normal HR, but the ventricles contract just a tad too soon - hence their name.

To start, let's confirm that you can sense a true PVC.

When you feel your heart beat, it's the Ventricles contracting. The Atria do not contract strongly enough for you to feel it. The only way to sense Atrial contraction is w/ a stethoscope & it is noticeably weaker in sound than the Ventricles contracting. I believe the "official " medical description is "lub-DUB" where the DUB is the ventricular contraction. (If I'm backwards, someone will call me on it!)

When you are just sitting there doing nothing w/ your mind in neutral, what you will feel goes something like this:
ThumP, ThumP, ThumP, thump, pause, THUMP, ThumP, ThumP.....

ThumP = a normal beat
thump - a wimpy beat - the PVC!
pause = a short pause that surprises & scares you
THUMP = a heavy beat that really catches your attention

The wimpy "thump" is because the ventricles contract prior to being full, so there's not enough blood in them for it to be noticeable - MOF, you may not feel this beat at all - some people do not, giving them a full 1 second or better sensed lack of a beat.

The pause is a compensating thing to help the heart get back on track into a Normal Sinus Rhythm.

The THUMP is the ventricles contracting when being slightly more full than normal, due to the pause.

It is the disturbance in regularity of your rhythm that catches your attention.

Single PVC's are harmless, but are disturbing. Consistent, long runs of them can lead to other problems, more serious in nature - like V-Tach or V-Fib. But I am evidence that singles are benign - w/ my monthly count by my PM.

Someone else said it - the PM can only take care of LATE or MISSING beats - in other words, speed things up. It cannot slow things down.The rest of your questions are not mine.

Hope this helped some on your PVC's

Donr


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