Afib

I have had my pacemaker for 2 years now and no problems.  My heart rate started to increase last month from 70 to 80HR.  The Dr. said I have AFib now.  He  hasn't reccomended any changes to my meds,  Just come back in 6 months for device check, Echocardiogram and Dr. visit.  Does any  else have this problem?  Evidently AFib is here to stay.  I am 81 so thats on the downhill slide!!  I take good care of myself, good weight, exercise daily and have a good life.  I have noticed that I am more anxious and depressed lately.  I do have one glass of wine most days, info I just read said  to discontinue wine (ouch).  Maybe not as have already  given up most deserts.   Any suggestions?


6 Comments

Welcome to the club

by AgentX86 - 2021-08-05 20:55:51

Afib is a RPITA but the "good" news is that if treated it's not dangerous. The risks are stroke and tachacardia induced cardiomyopathy (enlarging of the left ventrical caues by tachycardia). Treat the first with an anticoagulant (at your age Eliquis is the odds-on favorite) and the latter with some sort of rate control drug, usually a beta blocker.  ...and, yes, once AF is here it doesn't go away. It invariably gets worse. Afib begets more Afib.

Your pacemaker won't help Afib but it will allow proper treatment with rate-control drugs and not allow them to depress your heart rate too low.

Wine? No clear cause/effect but I did give up drinking after I was diagnosed with AF. I drank a we bit more than a glass, though. I found it easier to drink none than one (none for 15 years). After my bypass surgery, my cardiologist said that one drink a night couldn't hurt and may be beneficial. I asked how big "one" was I don't know why my wife whacked me. All I did was ask a question.

If I were you, I'd have the glass and smile.   ...and have a slice of that cheesecake as a chaser. Life is too short and completely wasted on kids. Enjoy! 81 is not too old to have fun. My mother was 95 when she died. She lived in her own home and traveled until the last ten years. Then then in a senior's home, in a private apartment.  She only started to slide the last year.

A-Fib

by ROBO Pop - 2021-08-05 21:14:05

Pretty common but not the worst that can happen. If you're asymptomatic then enjoy life.

I have A-Fib along with many other fine features and Whine almost every day. My kids tell me to stop but if it feels good do it. Oh and I have a glass of wine. I did talk to my dr about it. Doesn't seem to have any effect in my case. Ask your Cardiologist or Electrophysiologist. 

Atrial Fibrillation (AF)

by Gemita - 2021-08-06 07:36:28

Hello Rebecca,

Does anyone else have AF?  Oh yes, too many of us.   I have it (at 72).  My husband has AF (at 83).

You sound a healthy 81 year old and not in need of any drastic changes in your lifestyle, despite your AF.  For some of us wine, in fact any alcoholic drink, can be a most definite trigger for AF, but then so can many other things in life, even getting older and none of us can stop this.  If you are symptom free, have your heart rate under good control (60-100 bpm would be within normal range for heart rate, anything over 100 bpm would be regarded as tachycardia), and are protected from having an AF related stroke by taking anticoagulation, then I would say your AF is well managed.  

Of course we ideally need to manage any other health condition we may have as well, to keep AF under good control.  I am thinking here of high blood pressure, treating any sleep apnea if you have it, treating coronary artery disease, thyroid disease, diabetes, electrolyte disturbances and other acute health conditions (including inflammatory/infectious).  Sometimes AF can be triggered by lifestyle, from too much caffeine, tobacco, alcohol, anxiety and stress, gastric reflux disease and just about anything else, but sometimes AF starts for no apparent reason, so I no longer go looking for a cause.  With AF it can be frustrating to do so.

I see from your history that you have had an ablation for atrial flutter, so  arrhythmias are not unfortunately new to you.  I also see that you can experience high heart rates and that you suffer from hypertension, for which you are receiving medication (Metoprolol)?  

An increase in heart rate from 70bom to 80bpm would not concern my doctors, but of course our age, other health conditions, especially a heart condition could still mean this slight increase might be noticed or affect us in some small way.   Your doctors though are obviously not concerned for the moment, so I would be reassured.  They will keep an eye on you (hence Echocardiogram, device check to see how often you are getting AF and whether your heart rate remains controlled).  They may also monitor you for any other symptoms you might develop from your AF, like breathlessness, dizziness from the irregularity of your heart rhythm.  Providing your symptoms do not prevent you from living a quality of life, your heart rate is well controlled and you are protected from the risk of an AF related stroke by taking an anticoagulant, your doctors may decide to leave well alone.

How to stop AF is a question that we all ask.  AF is not curable, although with a successful ablation it can go into remission for long periods.  I have decided to learn to live with my AF on minimum treatment especially since it has remained intermittent since diagnosis in 2014 and my symptoms are well controlled.  It is certainly less drastic than hitting it with powerful anti arrhythmic medication or getting an ablation.  If I can keep it where it is, I will be well pleased.

By the way, I think you can treat yourself to the occasional dessert.  My husband being diabetic is able to treat himself from time to time and his blood glucose is well controlled now.  Enjoy your life Rebecca 

Me Too!

by Marybird - 2021-08-06 10:13:15

I've just recently joined the Old Folks Afib Club ( OFAC) myself, handed a diagnosis of afib and a prescription for Eliquis by my cardiologist. But other than the occasional flutter and "rollercoastery" feeling in my chest, I'm feeling just fine.  I too have lived with arrhythmias for many years, with one episode of a- flutter once, but it was never found to be afib before maybe as much as a year ago. 

Just wondering, Rebecca, if your afib was discovered on your pacemaker monitoring ( or inoffice device check) as perhaps intermittent short runs of afib, perhaps a small percentage of your total heart rate activity? I ask as you mention your doctor didn't adjust your medication, just the followups with this news. That seems to be the way afib "crept" into my life, with pacemaker monitoring reports to my cardiologist,  who then increased my metoprolol to keep the heart rate under control, but didn't prescribe the Eloquis until he got a pacemaker alert that I'd had more and longer runs of afib, including a 2 hr episode. Then I got the diagnosis and the Eliquis.

As I understand it, it's the rate control drugs that keep the ventricular rate ( that's what manifests as the heart rate) under control during afib- hopefully under 100. That's when you're likely ( with any luck), to feel ok. Though when you're in a-fib, your atria ( upper chambers of the heart) are more or less quivering so the atrial rate is much higher, but those ( unless you're experience rapid ventricular response, but that's another topic) hopefully won't get to the ventricles. The rate control drugs work to prevent the atrial rates from getting to the ventricles, so your heart rate may go up some but hopefully not all that much. 

Of course you can see the afib on an EKG, and your heart rate tends to be irregular. But as I have read, from a number of articles ( and pacemaker manuals I've read available on manufacturer's websites) describing asymptomatic afib detected on long term monitoring devices, including pacemakers, the devices can detect and quantify the high atrial rates occurring during afib/flutter, and they're reported as "atrial high rate episodes", with numeric rates that can range from 150 or so up into the 500-600 ranges ( this would be the "quivering of the atria). It seems ( from my understanding of what I've read) depending on the make/model of the device, the device report includes graphs, "electrograms" ( or something similar to an EKG graph) that allows a professional to distinguish between afib/flutter and various artifacts during pacing that may translate as high atrial rates. 

When I googled  "subclinical afib" the search results came up with lots of interesting reading. 

It can be scary

by TLee - 2021-08-06 11:14:37

I needed to see this particular topic today--it has helped me keep things in perspective. I have the same issues--afib that did not respond to cardioversion or ablation, now pacemaker & beta blocker. I was feeling really good for a few months, even getting over medication side effects, which were a whole other thing. Lately I have gone back to feeling some of the fatigue and the shortness of breath that we are all familiar with, and it was getting me down a little. I needed reminding that many folks live & live well even with the ups and downs of the wonderful world of arrythmia! There are things I can do, like checking in with my doctors to see if my treatments need adjusting, but the main thing is to make peace with my body. I don't have a 30 year old's body at 61, but I'm not one foot in the grave either. I need to work with what I've got, do what I can when I can, and stay positive--and that is true at any age. Rebeccaanne, it sounds like you are already very good at enjoying life, don't let this discourage you. 

Afib

by Old male - 2021-08-06 23:53:50

Just the latest in my cardiac ailments.  About 3 years ago started finding myself short of breath going up stairs, bending over or just walking.  Have stayed active all my life and just thought I needed a little more exercise.  Wasn't a constant situation as noticed only occasionally.  Already had ICD several years due to Vtac.  Previous 2 heart attacks, stents, bypass surgery.  Tried Cardioversion 3 times lasted short time.  Ablation mentioned but from what I've read, most either don't work or last only short time.  Taking Xarelto.  Have learned to just live with it and some days better than others.

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