I’m 33. I’ve had a fib for 5 years. Take flec and beta blocker daily. Probably 30% of the time my heart is pounding really loudly even though it feels like it’s in rhythm. I am almost always constantly aware of my heartbeat but sometimes it’s unbearable so it’s hard to sleep. I haven’t done anything about it because it’s still technically in rhythm during these times. Often I also get sharp chest pains particularly when I breathe in - especially deep breaths. The doctor didn’t seem too concerned about palpitations but I figured I would check on here as most on here seem to know more than a lot of doctors about this. Thanks in advance

At what rate is it pounding ?

It sounds to me like you are hyper-aware of your heart's motions. You may need CBT to attenuate that inclination.

You HAVE TO have faith in the devices you use to record your heart's output. If you have no faith in them, why would you trust them when they tell you you ARE in AF let alone when they do not? So, if you bother with them at all, then accept when they record, consistently, and reliably, that you are in NSR. What's left is what you 'think' is happening, or what you 'fear' is happening...when it apparently isn't. And I'm guessing it robs you to peace and sleep. So, if the medicos are not worried, and real and formal assessments show you're in NSR, then you need to find a way to unlearn your unnecessary preoccupation with the sounds and sensations of your heart. That would probably be cognitive behavioral therapy.

Have you checked your BP when you're feeling the pounding?

Difficult from what you say to come to much of a conclusion. Have you run an ekg during these "pounding" episodes? If not, Apple Watch or a Kardia device would allow you to take an ekg at those moments. Could be simply ectopics, or something else, or nothing. Have you had a 12-lead at an ep's office to monitor your Flecainide? Always advisable when symptons present after taking it, or after a dosage increase. As to the pain during deep breaths, what does the doctor say? Have you seen a pulmonologist to rule out non cardiac causes? If you feel that your symptoms aren't being taken serious enough, a second opinion is a good option. It could be something or nothing, but always best to rule out the something(s).

Jim

Can you identify times when the pounding is worse or better?

For example, I find that I can feel pounding if I'm lying on my back or leaning back against a hard surface like a chair. Avoiding these things has helped whether in NSR or Afib.

Will do you sleep on your back? I notice it more in that position.

“It sounds to me like you are hyper-aware of your heart's motions..”

It’s a heightened sense some have. I can feel a PAC. I can’t hear a missile siren for the life of me but I can feel my heart when it misbehaves. Go figure.

I can I recommend a sleeping aid. I slept like a baby and before I started flec back in 2004. It’s not common but insomnia is a side effect to some.

Will:

I have had pounding heart/palpitation issues while in NSR, but not to your extent. In my case, I attributed it to excess adrenalin or an over reactive nervous system that was out of kilter, as mild exercise moderated these symptoms.

Although not that common, Flecainide can cause a wide variety of symptoms including a pounding heartbeat. perhaps ask your Dr. about a trial getting off the Flec temporarily.

Something else may be going on with your health. Sharp pain while inhaling is a sign of inflammation in the lungs or rib cage.

I found this article from UM that categorizes chest pain as either Muscular or Cardiac. It is an easy read.[www.med.umich.edu]

Have you considered ablation? Pulsed filed ablation might be a good solution for you instead of taking medication long term.

My heart was loud all the time before I started a serious meditation routine. I was doing 2 hrs in the morning and 2 hrs before bed every day (kept a journal and never missed a day). Did this for 4 years, now I do shorter meditations before bed, sitting up in bed. My heart is never that loud anymore unless I'm in afib, then it's all I can think about. I'm sure you know the feeling.

If you want to learn meditation, check out youtube Buddhist monks like Yongey Mingure Rinpoche and others. Once you click on the subject it should keep sending you recommendations.

I've found that using a "White Noise Machine" which you can find cheap on Amazon is often helpful with that problem. It produces sounds that drown out the pulse noise but also allows you to fall asleep.

As Carey had mentioned you also need to determine if your blood pressure reading is high when this occurs. If yes, then working on lowering your blood pressure could solve the issue.

Thank you for all the replies. My blood pressure is often quite low when it is measured and has never been high in my life. I am fit and low body fat percentage so I doubt it could be that. I had a blood test measuring the amount of flecainide in my blood and it came back low despite taking 200mg every day (admittedly I had skipped one dose the night before).

The symptoms are not overly bothersome - heart beat is worse when I just stand up after lying down (despite not even exerting myself) or when lying down. Though the pulse on my left side is always extremely pronounced and on the right it’s very weak. I can live fine with the symptoms I was just wondering if it was something to be concerned about given the expertise on this forum or whether others experience the same. Prior to being diagnosed and being on flec I couldn’t even tell my heart was even there.

I don’t think getting off flec is an option for me according to the cardiologist unless I go the ablation route - but given my country is quite small (New Zealand) I prefer to wait until I’m older and can afford to travel to get ablated by one of the experts.

Quote
Will1789

I don’t think getting off flec is an option for me according to the cardiologist unless I go the ablation route - but given my country is quite small (New Zealand) I prefer to wait until I’m older and can afford to travel to get ablated by one of the experts.

We in New Zealand do have an expert in Dr Hooks who did his training at Bordeaux. He has more than 10 years experience and is doing 300 plus ablation a year. He uses RF and does complicated ablations.
He is not as famous as Dr Natale but I would put his ability up there with the best.
He was also recommended by Dr. Pierre Jais.

Hi Will
Another Kiwi here, I haven't been on this forum for ages, but just spotted your thread.
I can hear my pulse, heart pounding when sitting or standing still. I think I've had this all my life, just thought it was normal. I've been told it is pulsatile tinnitus, as I "hear" my blood pumping blood past my ears. If I block my ears with my fingers, so you get that fuzzy sound as if under water, I then can't hear my heart beat.
I find it quite relaxing hearing my heart beat pounding nice and regular. I therefore know immediately if I go into AF, and therefore find it quite disconcerting when in AF.
Anyway briefly my back story, male, 52 years old, fit and active, 68kg, first diagnosed with AF approx 5 years ago. I've had a cryo ablation Sept 2022, Waikato hospital (I live in Taranaki).
Send me a PM if you want to talk with a fellow NZer, or to discuss the ins and outs of our public health system. I went public with my ablation, about 6 months on the waiting list.
Nga mihi Blake

Thanks Blake. I have been getting exceptionally bad palpitations the last few weeks. Have often been feeling my heart beat in just my right ear which has made sleep difficult on the nights I have it (about 60% of the time). It’s still present in the day but not as noticeable. I have never had this before and it from googling it seems it could be pulsatile tinnitus as well. Now the last two days straight I’ve felt every single heart beat surging up the veins on both side of my brain near my temple/ear region. Is that what you feel? I am not hearing the blood this time per se like I hear the heart beat within the right ear, just feel two big veins in either side of my brain surging violently. This is super noticeable all the time so I hope it lets up soon. Sometimes the pulses feel very violent. Have you experienced anything similar with the tinnitus?

I hope your ablation was a success. I haven’t had the courage yet to get an ablation - although when I was first diagnosed with afib around 27/28 I decided to jump on the best health insurance policy I could (which now covers my afib). Haven’t used it yet though as I am still far too scared to want an ablation. I will say I’ve tried to book a doctors appointment to discuss these symptoms and my doctor was booked up a month in advance so a long wait

Always heartening to come on here and read others experiences particularly when I cannot sleep because of it

I hear/feel my pulse 24 hours a day. I think I have always been aware of it. Just sitting here typing this message I can feel it chugging away nice and slow and steady (approx 60bpm, although it drops to about 40 over night). My blood pressure is good.
I don't mind it, I just thought it was normal. If I exercise or have to speak in public I feel my heart really pound.
When I really think about it I feel/hear it on the left hand side, upper neck under the jaw. The reason I believe it is tinnitus is that I can't detect it if I put my finger in my ear and hear that muffled sound but no HB. Maybe I'm just hper aware.
I'm a good sleeper so it doesn't keep me awake at night.
In terms of my ablation, I had a cryo ablation of all 4 pulmonary veins. It hasn't been a 100% success, as if I try and stop the meds I go 10-14 days NSR, but will slip into AF if I get stressed. I however quickly revert if I take a PIP Flecainide (within 20-40 minutes). Post ablation the AF is far less chaotic. Stress is my biggest trigger. I've never been able to pinpoint a particular food or coffee. I'm an occasional drinker of alcohol and then it's only a couple of beers or coupke of glasses of wine with the wife. I go weeks to months without alcohol.
I'm booked in for a touch up RF ablation 7th May, Waikato hospital, public health system. Hopefully they will track down a rouge signal or rejoin.
I'm on daily bisoprolol 2.5 for rate control and Flecainide 100 for rhythm control. These are keeping AF at bay, no ecotopics, palpitations or feelings of going into AF. I get no side effects from these meds.
Cheers Blake