Atrial fibrillation - some questions

[Arnie Pye]

I have never really understood what atrial fibrillation is.

1) Can people feel it when they have it?
2) What are the symptoms?
3) Can it only be diagnosed by a medical professional with an ECG machine?


I have some very brief (less than 5 seconds usually) and occasional episodes of arrhythmia, missing beats or extra beats. I don't know if this is a sign that could suggest I have AF. I don't get chest pain. I do get episodes of fast heart rate (roughly 100 - 125) and my pulse is high in range most of the time.

I have a Pulse Oximeter which shows what the pulse is doing in a little trace at the bottom of the display. Could it be used to diagnose AF?

What I actually own is this :

but the picture of the trace in that picture is nothing like the one I get in real life. What I get is much more like this picture :

Does the trace tell people anything about AF?

The NHS info on atrial fibrillation is not very good. I have to "check and assess my pulse". What?

Checking and assessing your pulse can give you a good indication of whether you have atrial fibrillation, but a full medical investigation will be needed before a diagnosis can be made.

My response to this is, "Yes, I have a pulse, which is super". My pulse rate is usually in the 80s or 90s, but can go higher, sometimes for no obvious reason.

Is any of this worth following up? I just wish I could decide for myself whether I have a problem. I really don't want to go and see a doctor about it unless I have the condition because I foresee problems like being bullied and being told I must take statins (Not a chance!) or "Take these BP drugs". The last time I took drugs (beta blockers) to lower my heart rate they also lowered my BP to the extent that I was a whisker away from fainting when I stood up, and when I walked up a slight hill to get to my nearest bus stop.

 

[yME]

My partner has this diagnosis also ME. HR often - twice a month reaches 140-170 for one hour with peaks of 240 despite being on BB. She certainly feels it and has pain across shoulders but not into arms with post weakness for 24 hours. Pallor changes rapidly. She often gets mini episodes and finds rubbing her chest gently reduces the duration. The specialist suggests bending forward during episode which does not do anything. Another suggested holding an ice cube in the mouth. Having caught several events on ECG in ambulance and at A&E the GP belatedly proscribed Cardicor which helped. as an aside the generic Bisulphate caused her a very cold nose. Just one of those ME drug sensitivities we assume. We have not found any trigger activity but she does experience a ‘foreboding’ feeling a few minutes prior to any episode.

 

[janice]

****This is simply my own personal experiences and are in no way a suggestion as to how anyone else should treat such things.****
************ I have no medical training what so ever. ***********

I find my heart goes into wobble mode /rapid beats a few hours after I have done too much.

This has been going on and off for me for over 10 years now.

Obviously I found this very unsettling and worrisome.

I was using a Polar chest strap years ago, in an attempt to increase my activity levels ( I know in hindsight, I'd been a mug thinking it might help, but then I was/am fairly desperate...........like most of us are I'm guessing).
Plus I used to be a competitive swimmer in my youth, so managed to convince myself that horizontal exercise like swimming would help me......Doh! what an idiot I can be.

If I have overdone , my HR is over 150 bpm for > 1hr and < 3hrs. The Polar app told me I was over doing/training and must stop.

Unfortunately NHS has not been able to help me........... yet?

One A&E visit told me if my palpitations went on for more than ten minutes I should go back..............well obvs that wasn't going to work.

In A&E they seemed worried and repeated the EEGs three times with 30 minute spaces, they gave me the ECG clearly telling me to show it to the cardiology consultant when my GP referred me.

They also asked me if anyone in my family had ever suddenly dropped dead........genuinely, that is what I was asked with my HR over 150.

That was all back in 2010...........but the same heart wobbles thing is still happening to me. My GP two weeks ago said she would refer for a 24 hour monitor with Cardiology dept. However I am not going to chase referral cos I don't want to go through what happened in 2010.

The cardiology consultants didn't want to see the traces given.?

The cardiology deptdid do checks of EEG and ECG and assured me there was nothing wrong with my heart. Then added "You could even run a marathon". So I asked "Well what about the ME/CFS?) and he just looked at me blankly.............

Then another cardiology consultant told me the "It's because you are slim that you can feel the extra beats. Most people wouldn't be able to."

You couldn't make it up.

Ho Hum,
Apologies for the splurge but I wondered if it might be some help to somebody else, so to not take their poor treatment too personally.?

 

[Arnie Pye]

The episodes being described that affect your partner, @yME , sound an awful lot worse than anything I have ever gone through. But it is disappointing that she needed a doctor to diagnose it. I was hoping to do a self-diagnosis, but I'm not clear if I can do that.

Just for info, please note that low iron can cause increases in heart rate / tachycardia and (if it gets bad enough) chest pain, and also note that the NHS barely mentions this, however there is useful info on drugs.com (an American site, often with more complete info than the NHS).

https://www.drugs.com/mcd/iron-deficiency-anemia

My tachycardia started as a result of catastrophically low iron. I ended up having to fix my iron problems myself. I did manage to get rid of the chest pain that way, although I've never managed to get my iron and ferritin levels to where I want them.

Perhaps your partner could get her iron levels tested.

 

[Trish]

I think if in doubt ask for medical advice from a doctor.
Here's some information from the NHS. NHS:https://www.nhs.uk/conditions/atrial-fibrillation/

 

[Kitty]

Is any of this worth following up?

I don't know if it helps, but my ECGs have all been done by nurses, so I don't always get subjected to the full-on health check from the GP! My most recent ECG was ordered after an online exchange of messages about something else altogether. The background is that I have asymptomatic, probably hereditary bradycardia, which the GP's suddenly become interested in after she noticed it on my notes—even though, with a resting heart rate of 50-52, they're hardly going to do anything about it.

Anyway, I don't think you'll escape some contact with your GP if you want it investigated. It's not always a straightforward thing to look into, simply because it doesn't tend to happen when you want it to!

They'd probably start with a discussion about the symptoms (possibly online if that's what you prefer?), maybe an ECG (a five minute lie-on-the-table job), and if they're worried, they could ask you to wear a Holter monitor for a week (a pain in the arse, but it can help because it records things that maybe only happen every few days).

 

[hibiscuswahine]

People describe fluttering in the chest with AF, this is a serious arrhythmia as it can cause heart failure (compare to a few ectopic, missed beats) but is readily treatable with medication. Symptoms as per the NHS site, A pulse oximeter is not a reliable test for AF, it is not just how fast the HR is but also there is a certain pattern on the ECG. Also not to scare you but if you have covid this could be because the virus is interfering with your heart, so strongly suggest you see your GP if you have symptoms and often a nurse can do your ECG to rule this out and other heart pathology which might require further investigation.

 

[SunnyK]

I have never really understood what atrial fibrillation is.

1) Can people feel it when they have it?
2) What are the symptoms?
3) Can it only be diagnosed by a medical professional with an ECG machine?


I have some very brief (less than 5 seconds usually) and occasional episodes of arrhythmia, missing beats or extra beats. I don't know if this is a sign that could suggest I have AF. I don't get chest pain. I do get episodes of fast heart rate (roughly 100 - 125) and my pulse is high in range most of the time.


.

I realize I'm very late to this thread, and hopefully you've received helpful guidance on this by now. I first started feeling my heart "skipping beats" (and I'm nearly always aware of that sensation, though it's most prominent when I'm at rest and not distracted) when I had pushed myself far too hard in my last yr of high school and first semester of university. In fact, after the latter, I underwent tons of testing because I had pronounced tachycardia (resting heart rate over 150 beats/mn) as well as skipped beats. But it wasn't until the early 2000s, when I was in my 30s, that I started having skipped beats or a "running" arrythmia that lasted 10-12 beats. At that time, I wore a holter monitor (heart monitor) for a month and a cardiologist diagnosed me with a-fib. He said it was too mild to warrant treatment with beta blockers, but I still freaked out because I had older family members who'd had to have ablation and all sorts of scary treatments.

Fast forward to 2021, once we'd moved here to CA and I saw a new cardiologist. She was horrified that I'd been given an a-fib diagnosis and explained that what I actually had was atrial tachycardia--less serious and not requiring treatment. She said she would call arrhythmia (skipping beats, irregular heartbeat) atrial fibrillation only if episodes lasted 30 seconds or longer. Mine last at the longest 12 seconds or so.

I freak out about heart stuff so always want cardiac issues seen by a specialist, but if you don't have access to that and are experiencing occasional arrrhythmia that doesn't more than several seconds, you probably have to reason to worry. But I am not a doctor, and I'd say that a heart monitor (not just an ECG, since you may not have skipped beats during such a short test) worn for several weeks would be the best way to test.