New To A Fib; General Quesions

Hi, I was diagnosed with A fib about 6 months ago after having a routine EKG with annual checkup.In hindsight, I realized that I had been have symptoms periodically, including fatigue and shortness of breath. Monitor showed A fib episodes about once per week. Heart structure is ok. Am now taking low dose beta blocker and blood thinner.I also have slow heart rate- bradycardia, which seems atypical. Drs are reluctant to begin rhythm control meds, and seem t be leaning to ablation.


Questions are:


Could ablation help bradycardia?
Is ablation targeted to a particular portion of my heart based on my specific test results, or does it target same area in all with AFIB?
How can I check ablation record/volume of Dr?

It seems that many posters here know when they are in a Fib. Sometimes I do, but not sue if feeling palpitations necessarily equates to A fib. How can I tell the difference?

Other thoughts?

Thanks very much.

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houndym
Could ablation help bradycardia?

Not really. Post-ablation you will likely notice an elevated heart rate, but that is due to the inflammation caused by the procedure itself. Once that subsides many people report rates returning to normal.

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houndym
Is ablation targeted to a particular portion of my heart based on my specific test results, or does it target same area in all with AFIB?

It depends on the practitioner. The standard ablation procedure is called a Pulmonary Vein Isolation (PVI), which is using either radiofrequency (RF) energy to heat or a cryoballoon to freeze the tissue in the left atrium surrounding the veins. Either way this creates what is hoped to be a durable scar that blocks the electrical activity in the veins from spreading out to the remainder of the left atrium.

Beyond that, it really depends on the skill level of the EP, and this is the crucial variable in deciding where to go if that is an option for you. More skilled EPs do ablate beyond the standard PVI and have higher success rates in identifying and removing other trigger areas in the left atrium. Do take the time to read up on this site and ask questions to make this critical decision. Do not just "jump into bed" with the first doctor you find. Maybe he or she is the right choice, but due diligence is key here.

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houndym
How can I check ablation record/volume of Dr?

Ask him or her. Also, many practitioners are known to folks here. Just ask.

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houndym
It seems that many posters here know when they are in a Fib. Sometimes I do, but not sue if feeling palpitations necessarily equates to A fib. How can I tell the difference?

If you can afford it, the Kardia device is a gold-mine. It is very easy to use and quite accurate. They are around $100 (US) but sometimes go on sale for less. There is also a smartwatch device, although I do not have experience with that one.

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houndym
Could ablation help bradycardia?

No, but stopping the beta blocker will. Unless you had bradycardia before starting the drugs, that's most likely the cause of the bradycardia.

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It seems that many posters here know when they are in a Fib. Sometimes I do, but not sue if feeling palpitations necessarily equates to A fib. How can I tell the difference?

As Wolfpack said, a Kardia is the best way, but without one the easiest way to detect afib is to simply feel your pulse. Afib is always an irregular rhythm, so if your pulse is irregular and remains that way continuously (vs just momentarily) then you are most likely in afib.

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houndym
(...)
It seems that many posters here know when they are in a Fib. Sometimes I do, but not sue if feeling palpitations necessarily equates to A fib. How can I tell the difference? (...)

You might take a look at some vids from Dr Sanjay Gupta, on Youtube.
Here's one about the heart palpitations.

Thanks very much to all--great information. Does anyone have knowledge of electrophysiologists in the Pittsburgh area?

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houndym
Thanks very much to all--great information. Does anyone have knowledge of electrophysiologists in the Pittsburgh area?

Yes, and boy did you luck out. He's a Natale protege and although Philly isn't Pittsburgh, it's as close as you're going to get for this kind of EP. Go see this guy.



Edited 1 time(s). Last edit at 04/25/2018 09:48PM by Carey.

houndym,

You've gotten excellent advice here. If you want to understand what truly normal rhythm feels like, take the pulse of a friend without afib. You'll feel the regularity of the pulse. Then take your own pulse, if it feels similar, then you are in normal rhythm. If it doesn't, you may likely be in afib. If you look at a graph of heart rate vs. time in afib, it looks like a seismogram during an earthquake. A huge beat to beat heart rate variability. For example, in afib, the heart rate range may go from 60 to 130 BPM. In normal rhythm, it may be more like 65 to 72. When you are in normal rhythm, it is hard to tell the difference between 65 and 72. Also, in afib, the pulse wave amplitude or "strength" may vary a lot. In other words, some beats feel weak and some feel very strong.

George

There is also something called PAC's that you need to familiarize yourself with. PAC's are Premature Atrial Contractions, that some people confuse with AFIB. These can manifest is various frequencies, many times they are rhythmic, occurring every 2nd, 3rd or 4th beat. This is still NSR, but can cause Palpitations. I recommend Googling EKG Images of NSR, AFIB and PAC's. This will help you tell just by feeling your Pulse what Rhythm you are in.

Another helpful Tool is a Pulse Oximeter. In AFIB, the HR will jump around and vary greatly (mine varies from 70-110) on the readout from the Oximeter, whereas NSR, and PAC's will show a stable HR. These only cost $10+

I was diagnosed with AFib 3 years ago when I was at urgent care for a respiratory infection and passed out. Since then, I’ve only had an episode about every 8 months until last month when I started having them every day or every other day. I’ve given up trying to figure out what triggers them. My electrophysiologist told me it’s time for an ablation. I am 72 and very nervous about it but sure don’t want a stroke or heart attack!. My doctor says he does about 400 a year. Is that considered a lot? I live west of Ft. Lauderdale FL area.