AF frequency and ventricular response rate.....

Hi folks,

Just a thought further to reading some of the threads below.

Do those who have 2-3 day episodes with just 2-3 days NSR in between typically have a low and largely asymptomatic ventricular response rate whilst in AF?? (I sure hope so!) And do those who only have one or two episodes of AF per year typically have a high and uncomfortably symptomatic ventricular respone rate whilst in AF?? Is there some sort of correlation in evidence here? If so, does it imply that a heart which for whatever reason is intrinsically more reluctant to go into AF will have a high (and symptomatic) ventricular response rate when it is finally shoved into AF?? Maybe I'm just spouting nonsense here....... or am I? Any views anyone?

Mike F.

Hi Mike, my AF is currently coming around every 9 days (lasting 27 hrs).
I have a fast ventricular response (180-200bpm if I'm walking around) which could be classed as 'uncomfortably symptomatic' though I do tolerate the high rates quite well for short periods (10-15 minutes). If I rest up I can usually get it below 130 bpm after a few hours.

Although everyone here would class me as having vagal AF, betablockers are the only thing I've found that even remotely control the rate (without them I've gone as high as 280bpm)

All the best
--
James D

Hello James D. --- I'm curious as to whether your ventricular response is irregular as well as rapid. Thanks, Mary.

Hi Mary - yes, it's irregularly irregular.
For an example see [james.dialsolutions.com]
--
James D

Mike:

When you say "largely asymptomatic ventricular response" it leads me to assume that you're not experiencing irregular rhythm in your ventricles.

If not, then the question comes to mind whether you're actually in AF during those times, or whether you're simply experiencing an accelerated rhythmic period that might be due to elevated BP or a hormonal shift, or some other cause, even dehydration. I've suggested this before, since you and others have mentioned elevated rates without rhythmic changes in the ventricles.

Even James D in this thread indicates that his rhythm, as if those with AF, is "irregularly irregular," as in the definition of AF.

Your question just doesn't suggest AF, as I know it to behave in me.

More input welcome.

All the best...Jerry

Jerry,

When I said "largely asymptomatic ventricular response rate", I did in fact mean a largely asymptomatic irregularly irregular ventricular response rate!! I.e. a ventricular response rate whilst in AF which causes - owing to its rapidity (e.g. James' quoted rate of 180-200) syptoms such as lightheadedness, panic, and sweating etc. Whilst I appreciate your input I can assure you that I know first hand what an episode of AF entails as far as irregularly irregular ventricular response rates. I have noted that some posters to this forum experience AF episodes which have slow (irregularly irregular) ventricular response rates which effectively result of no symptoms and no awareness of even having AF without feeling their pulse of having an ECG.

Further to posting the above post at the head of this thread, it did occur to me that my suggested correlation was perhaps a little off the mark given that it has often been commented on this forum by Hans and others that AF episodes tend to become less symptomatic the more episodes one has as the years go by......... whether this also implies that the (irregularly irregular) ventricular response rate decreases the more episodes one has (as frequency of episodes increase as the years go by) I'm unsure.

Cheers,

Mike F.

Whew! It's hard to follow that line.

Mike describes:
"largely asymptomatic ventricular response rate", I did in fact mean a largely asymptomatic irregularly irregular ventricular response rate!!"

I am vagal. Fortunately, my episodes are relatively infrequent I am asymptomatic generally, although I experience what I believe to be heartburn almost every episode. My HR goes as high as 170 and is irregular. However, if I pace gently, it settles down to about 130 or so and if I lay down, it may go a little lower. I think that is probably a largely asymptomatic irregularly irregular ventricular response rate, but am not certain.

By the way, an interesting little thing I've noticed with my pulse monitor is the change in my rate. When I go into afib, I am usually in bed. Standing up, my HR jumps to about 170 and then it goes down after I am up a minute or two. It seems to jump around, according to my monitor, and may be at 130 for a while, then 150, etc. If I can get it to "bounce" down below 100, that usually means I am about to convert.

John,

If you are relatively comfortable during your AF episodes, then you are indeed experiencing a:
"largely asymptomatic irregularly irregular ventricular response rate"!!

Your monitor bounces around since it is recording snapshots of a few seconds and the irregularly irregular ventricular response rate of your heart whilst in AF means that the number of times your ventricles contract whilst in AF will vary (hence the irregularly irregular bit) from one few second snapshot to the next.

Well at least trying to understand the brain-cramping nature of the above kept your mind off AF for a while!

Best wishes,

Mike F.