A-Fib or Not???

[smccormick]

Hi all,
I have been reading this forum everyday for the last 3 yrs, but rarely post. ( No need to - seems all my questions are answered before I ask!) I do have one question. I've read many posts about some of you going in and out of a-fib. How do you know? What does it feel like? I have episodes of my heart rate speeding up to 90's (usually runs about 60-64) when I'm laying in bed or sitting on couch watching tv, nothing strenuous and then I get this really really bad tightening in my chest and it runs down my left arm. This lasts anywhere between 10 min to 40 min. Then just goes away as quietly as it came on. I have told my doctors in Cleveland about this but I can never ever catch it on the monitor. The only thing that shows on the heart monitors are pvc's (harmless they say) but the last monitor showed in a 24 hour period I had 362 pvc's. Harmless but really annoying. So, how do you guys know it's a-fib and does it feel like what I described. When I have these episodes my heart is a steady beat but beats hard ( I can take my pulse without feeling any pressure points) but no skipped beats just fast & hard.

[Sarah]

Re: A-Fib or Not???

as someone who went in and out of a-fib for two years and is now in afib all the time, i can tell you that afib is very different from tachycardia.

a-fib can be slow or fast, although it is usually fast. however, it is always irregular. there will be many skipped beats and almost no pattern at all. it can be hard or soft, but it is the pattern --the lack thereof, really-- that is the hallmark of afib.

for me, i can feel my heart "turn over" when it switches from normal to afib and sometimes feel the beats in my chest when i lay on my left side.

what you describe sounds like just what the doctor says it is.

s

[cynthiaG]

Re: A-Fib or Not???

I've been told I have atrial tachycardia, but they way you described A-fib sounds similar to what I've experienced. I always thought that A=fib was more of a 'fluttering'?? When I get tach, my pulse is irregular and my heart feels irratic

[Rich Miller]

Re: A-Fib or Not???

Sarah, I am not the expert on hocm that you are but...I was in a-fib 2yrs ago that was a regular very fast rythum 135-140 bpm.when my family dr listened to my heart and i asked him if i was still in a-fib he said " no why" and i told him that i was scheduled in 3 day for cardio version and i was glad i wouldnt have to go, so he listened again and said he couldnt hear it but lets run a strip and sure enough there it was still in a-fib just not the normal a-fib but hey i have to be different.ok theres my 2 cents worth .
Happy New Year Everyone,be safe and let the amatuers have the rd.
Rich

[Largehearted]

Re: A-Fib or Not???

Hi everyone. Whenever I have been in a-fib I always knew it. My resting heart rate goes anywhere from 120-160 and is so erratic that is is very difficult to take a pulse. My current meds (120 Betapace twice a day)seem to keep a-fib at bay as well as do a much better job controlling PVC's. I used to feel PVC's all the tme. Now it is so rare that when I do I really sit up and notice. It's nice not to feel your heart beating.
Peace,

Leon

[EpLaurie]

Re: A-Fib or Not???

Hi guys,

When Rich said his afib was really regular... I just wanted to explain that many times people can go in and out of afib and a flutter (they can alternate back and forth all the time.)

A flutter is a different rhythm that still originates in the upper chambers, usually the right atrium but can be in the left atrium also. Aflutter can be a much more regular rhythm (it can also be irregular) but not like afib.

The focus for afib is usually in the left atrium in the pulmonary veins, but can be in other areas of the left and right atrium. Afib is totally chaotic, meaning the atria are just quivering, they are not actually contracting or pumping. Depending upon how many of those quivers get through to the ventricles (lower chambers) determines how fast or slow your heart rate will be when you take it (if you are in afib). Same thing with aflutter (as far as only so many beats get through to the ventricles,) but aflutter is a much more organized rhythm.

I just wanted to add that. Don't know if that helps or makes you more confused.

Regards,
Laurie

[Sarah]

Re: A-Fib or Not???

ah, yes, the vagaries of HCM...

when your rate is that high (135+), i could understand it might be harder to hear the afib.

i've had "flutter" too and this has been explained to me as a mix of regular and fib, alternating in "runs" (as in a run of tachycardia).

cynthia -- if your heart is skipping beats and/or very tachy, it could feel "fluttery" but i can't diagnose you from here. if i remember correctly, you've had been checked out and are awaiting holter results --if there was any afib, they'll see it and treat it.

some people can be in afib and never feel it at all. most doctors are shocked that i know immediately when it happens.

....everyone is different....

s

[cynthiaG]

Re: A-Fib or Not???

thanks. funny how it never happens when you have an event monitor on! I had one on for a month and there were a few funny things but not a full blown episode, but the doctor did say that it was coming from the upper portion and told me it was atrial tach. When it happens, it's irratic I've had stress test and MRI. I'll ask next week when I see my local cardiologist

[EpLaurie]

Re: A-Fib or Not???

Hi Cynthia,

there's an excellent tutorial on SVT (supraventricular tachycardia) it's technical but shows fabulous animated graphics of atrial fib, atrial flutter, and normal sinus rhythm + various other tachycardias that don't pertain to this conversation. you can access it through this URL:
http://www.blaufuss.org/SVT/index.html


this tutorial also shows how these rhythms are ablated using radiofrequency ablation which isn't a topic in this thread but is interesting. The graphics and rhythm strips are fabulous. I encourage you to check it out, it will clear up the differences between atrial fib, atrial flutter and normal sinus rhythm.

hope this helps,
Laurie

[Reenie]

Re: A-Fib or Not???

Guys, remember first that I'm not an HCM'er, this SVT is what I had and what I had the radio frequency ablation for. My records indicated that I also had some atrial flutter and had some recorded instances of tachycardia at a rate of 145 on both digoxin (not recommended for HCM) and Inderal. Just thought I'd throw that in here.

Reenie

[EpLaurie]

Re: A-Fib or Not???

Hey guys,
I should probably throw in that I'm not an HCMer either. I'm an EP (Electrophysiology) nurse. We study the heart's electrical conduction system. I've been in this subspecialty for 13 years, been in nursing for 20. I contribute daily on the Zapper ICD site (www.zaplife.org) voluntarily, and got interested in this site because we have quite a few HCMers. I read this site daily, but because my expertise is not in HCM, I don't post much.

Since my expertise is in heart rhythms and ICDs and Pacemakers, I decided to start posting if I saw something that I could meaningfully contribute to. I usually like to throw in URLs so that you can access the info first hand if possible.

Just thought I'd do a little intro of myself. Now I'm going to redo a whole post that I had prepared for another thread on this site, then lost before I submitted because my 5 year old decided to get on Barbie.com when I left my laptop unattended!

If I can be of any assistance re: the above, please feel free to PM me.

Warm regards,
Laurie

[smccormick]

Re: A-Fib or Not???

Thanks all of you for all the info. I have a holter monitor scheduled for this month so maybe if I'm lucky I can catch it! I really appreciate this site, it is sooo helpful.

[Deedee]

Re: A-Fib or Not???

I've had irregular beats (never on a monitor though) and sometimes just very fast and fluttery beats (not on a monitor either.) I didn't really know about them being described with different words! I would like to learn more about the right words. It will help me talk to my doctors a lot, doesn't everyone agree?

What are pvc's again? We need a sticky thread or a FAQ that explains all of these HCM and heart-related abbreviations so bad. PLEASE somebody write an abbreviation FAQ and a little HCM dictionary. It's needed really badly. I'd do it myself instead of begging for someone else to do it, but I need it myself!

We have tons of new people all the time and new to these short-cuts too... I'm sure it's frustrating when you're new and confused and possibly nervous and scared as well. You can eventually memorize all this stuff if you read HCM info a lot; but a nice, easy to use FAQ look-up all in one place would really be nice; and I think 4hcm.org is the perfect spot for it.

Just a thought. Well, I'm off to check out Laurie's nice link, I love to go see things for myself Thanks for the link.

Deedee

[EpLaurie]

Re: A-Fib or Not???

Hey Dee Dee,
was up in the middle of the night for something, and while I was waiting, I searched some of my favorite patient sites for heart related glossaries/topic lists. These URLs will be helpful for quick cardiac abbreviations/info:

Illustrated Glossary on Guidant Website
http://www.guidant.com/webapp/emarke...ev2=glossary#P


On heartcenteronline.com website you can access a lot of info without registering, but eventually they will prompt you to take a few minutes and register (it’s free) and then you can continue immediately.

The Arrhythmia Center @ HeartCenterOnline
http://www.heartcenteronline.com/myh...=31&searchterm

A-Z Topic List @ HeartCenterOnline
http://www.heartcenteronline.com/myh...curpage=search

Have fun! and hope this is helpful
Laurie

[EpLaurie]

Re: A-Fib or Not???

Deedee,

Sorry, forgot to tell you what a PVC was.

Since I was already on the other sites, I just pasted the following from The Arrhythmia Center @ heartcenteronline.com:

Premature ventricular contractions (sometimes called PVCs or VPCs or benign ventricular ectopics) are a fairly common type of abnormal heart rhythm (arrhythmia). In the normal sequence of events, a heartbeat is initiated in the top right chamber of the heart (right atrium) and subsequently conducted to the bottom chambers of the heart (ventricles). A premature ventricular contraction occurs when the ventricles fire early (prematurely), before the atria. They may be caused by fatigue, caffeine, alcohol, nicotine or a variety of other factors. In many cases, the cause of PVCs is unknown.

Some people may feel skipped beats or galloping palpitations, and other people may not notice PVCs at all. In general, these irregular beats are harmless. However, diagnosing them and ruling out heart disease may be important. People are also urged to contact their physician if they experience chest pain or a sudden worsening of their PVCs. If necessary, treatment generally involves taking medication, such as beta blockers or antiarrhythmics.

Laurie