EKG Readings

I ended up in the ER a couple weeks ago with a very fast heart rate and high blood pressure. I was given Lopressor in my Iv which brought down my heart rate and lowered my blood pressure. I just read my EKG readings and they sound very scary. Can anyone tell me if you've ever gotten this description on an EKG? I'm new to all of this and to be truthful I'm really scared.
Thank you in advance for any insight into this...


Sinus Rhythm
Borderline prolonged PR interval

Ventricular Rate: 93 BPM
Atrial Rate: 93 BPM
P-R Interval: 199 ms
QRS Duration: 102 ms
Q-T Interval: 382 ms
QTc Calculation(Bazett): 475 ms
Calculated P Axis: 56 degrees
Calculated R Axis: 37 degrees
Calculated T Axis: 24 degrees


WAVEFORM

Atrial fibrillation
Repolarization abnormality, prob rate related

Ventricular Rate: 150 BPM
Atrial Rate: 143 BPM
P-R Interval: 117 ms
QRS Duration: 87 ms
Q-T Interval: 283 ms
QTc Calculation(Bazett): 447 ms
Calculated R Axis: 57 degrees
Calculated T Axis: -79 degrees

Lillyh,

I'm not a doc, but it looks like the reading you typed second was taken initially and you were in afib at that point. Apparently, after the Lopressor was given, you converted to NSR (good). The ventricular rate after conversion was a bit high at 93. Have no idea what your normal resting heart rate is, though it can be common for the rate to be a little high for a time after conversion. Tell us a bit more about yourself. What is your age. Any other conditions or meds. What is your BP normally? What is your resting heart rate normally? Are you active or sedentary? How are you metabolically? How is your weight for your body size. And so on.

Did they send you home with any meds or prescriptions?

The two risks to afib are 1) a prolonged high (> 100 or 110 BPM) heart rate (you got this taken care of and 2) an elevated stroke risk. The docs use CHA2DS2-VASc to decide if you need an anticoagulation med. Both of these risks can be managed with meds. After that, afib isn't always fun condition, but has a low risk of being life threatening.

Sorry you needed to join our group, but welcome!

George

There's nothing scary about that EKG. It'd be nice to see a visual picture of the trace. It sounds like that's a computer output. Computers suck at interpreting EKGs. But even so, based on the numbers, it's all fine.

Take a deep breath and relax. We've all been there. The first step in AF is overcoming fear. It's hard, but take notice of the fact that there are a ton of not-dead afibbers here on the forum. There's probably a reason for that.

You're going to be OK.

Lilly, I agree with George and wolfpack. There's nothing scary about what you posted and you're going to be okay. There's no reason for you to be afraid. But it does look like you've probably got afib. So the important question now is what doctor are you seeing? Who diagnosed this and what are they doing about it?

Thank you to everyone who replied.to my post . I feel a little better now. The ER doctor prescribed Metoprolol 50mg and told me to make a follow up appointment with my primary doctor. My primary doctor referred me to a cardiologist who I saw last week. He changed my medicine to Diltiazem 180 mg and a 325 mg aspirin every day .. I had an echocardiogram done yesterday but wont get the results for a week .I have a stress test scheduled for May 25th.
I'm 60 years old and I do not take any other medication. I do take a B complex vitamin everyday. I was healthy up until my ER visit or so I thought. I've been trying to lose at least 25 lbs.so I walk every day and I have a physical job (I'm a homemaker for sick and elderly people).I like to work outside in the yard and keep active.
My blood pressure fluctuates a lot ..It can range from 120/80 to 157/90. When I saw the cardiologist my blood pressure was 130/78 (I was on Metoprolol) and my pulse was 84.. i don't know what my resting heart rate is. How do you find out? I have a blood pressure machine at home. It just shows my blood pressure and pulse. I don't how I am metabolically? Another thing i will have to know.
My cardiologist said after all my tests results come in we will regroup and go from there. It is hard waiting though.
Again THANK YOU for your replies. I appreciate your knowledge and input.

Lilly,

Just a thought... I have had afib for 15 years, and B vitamins are absolutely a trigger for my afib. I have attempted to use them numerous times and within two days - afib. I stop them and I am back in NSR after a day. For me (an adrenergic paroxysmal afibber) B vitamins are a metabolic stimulant (think the main ingredient of energy drinks) - a sure trigger.

I stay away from all 'man made' concentrated supplements and eat extremely natural, organic and clean, with lots of water. If I do this my body does the rest and the heart calms. The body is wise, humans not so much...

Hang in there,

Jeff

Jeff,
Thank you for your reply..I agree.. natural is the best.(which is why I hate taking any medication) I will stop taking my B vitamins and see if it helps..

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Lillyh
i don't know what my resting heart rate is. How do you find out?

May have other comments later as am heading out, but you can use your BP machine when you are just sitting around and resting. That will be your resting heart rate. You can find your pulse with your fingers on several spots including at your wrist on your thumb side, Then look clock with seconds displayed (watch or on your phone). Count for 15 seconds and multiply by 4, or 30 and multiply by 2. Here is a sheet on it from the Mayo Clinic.

Thank you George I'll check it out ..

Lilly,

I might question the cardiologist on the 325mg aspirin. If he means to use that as an anti-coagulant (blood thinner), then I’m afraid he’s a bit of a dinosaur. There’s no value in aspirin as a blood thinner for AF and actually quite possibly harmful. If you do, in fact, require anti coagulation then the newer drugs like Eliquis are the proper choice. I know, we all hate meds, but if you need it then that is one to take. AF is a journey with twists and turns so you aren’t going to be “sentenced” to a med forever. But in the short term, please take care of yourself. AF raises stroke risk and you, nor ANYONE, wants to have a stroke. That’s bad. The bad kind of bad.

I agree with wolfpack's post and wondered if your cardiologist is a general cardiologist or an electrophysiologist (EP). I'm going to guess the former because an EP would never prescribe aspirin for you.

Do you know the answer to the question of whether your cardio is a PE? If not, we need to talk. You need to be seeing an EP, not a general cardiologist.

I was hesitant to take a 325 mg aspirin everyday also (due to bleeding risks). I'm afraid if I refuse to take the medication he prescribes he will refuse to treat me (and put me on a blacklist lol). He is not a electrophysiologist just a cardiologist...I know I need medication I guess by acknowledging I need medication it makes it all real. ).

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Carey
an EP would never prescribe aspirin for you.

.

Why is this? Thanks.

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NotLyingAboutMyAfib
Why is this? Thanks.

Because it's less effective than the NOACs and carries a significantly higher bleed risk.

I've seen many general cardiologists and PCPs prescribe aspirin for AF because that's what they learned in med school 20 years ago and they haven't kept up with their continuing education in that area. I've never seen an EP prescribe aspirin for stroke prevention in AF.

I just sent a message to my Cardiologist's office and explained to them that I'm not comfortable taking that much aspirin and asked if there was a substitute for it. I will wait to see what they say..

Why do many ER doctors who I tell— and can read my medical records — that I take eliquis religiously at 8 and 8 insist I chew a baby aspirin?

Is it because they see an elderly woman and think I may forget to take it? Malpractice? Or is there a good reason to take both?

My cardiologists nurse replied to my email and right after I told her why I didn't want to take a daily aspirin she asked why I didn't want to take aspirin.. lol She explained why I needed to take it and told me it was up to me- I could take it or not. She did not give me an alternative. So I guess it's their way or no way .I'll take the aspirin until I get all my test results back and then I'll find a new cardiologist.
That is a good question Susan.... I don't know the answer to it..

Lilly,

Fire your doctors. I’ve done it. It’s not fun, but remember you’re number one.

If you can, find yourself an electrophysiologist who is current on the AF treatments. I’m sorry you’re having to go through this, but know that many of us have. Like I said, AF is a journey. And journeys have captains. That’s you.

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wolfpack
Lilly,

Fire your doctors. I’ve done it. It’s not fun, but remember you’re number one.

Lilly, I agree with Wolfpack. You're getting bad medical advice.

Where do you live? (Just city or region) We might be able to help you find someone.

There are several electrophysiologists at the same practice my current cardiologist practices . One is the electrophysiologist that treated my mom.I will request to see him. It seems like doctors( and dentists ) in the same practice all seem to stick together . That has been my experience so far .

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Lillyh
It seems like doctors( and dentists ) in the same practice all seem to stick together . That has been my experience so far .

At the beginning of my afib journey, 17 years ago, had a cardio who told me digoxin was his favorite med. He also did not believe in vagal vs sympathetic triggers. I refused the digoxin and we had long discussions. He finally passed me off to the EP in the practice. When I told the EP how my afib presented, he said, "you are obviously vagal and there are certain meds we won't prescribe for you." I had to bite my tongue to not suggest he should give his partner an in-service.



Edited 1 time(s). Last edit at 05/15/2021 05:16PM by GeorgeN.

Some research on B vitamins -

Google PDF - Cardioembolic stroke: everything has changed

It is also increasingly recognised that high levels of homocysteine, often due to undiagnosed metabolic deficiency of vitamin B12, markedly increase the risk of stroke in atrial fibrillation, and that B vitamins (folic acid and B12) do prevent stroke by lowering homocysteine.

I spent some time researching the best multi-B supplement and take 1 of these a day (unaffiliated) (Consumer labs doesn't even note this!!!)

[www.amazon.com]

Almost all others use pyrodoxine instead of Pyridoxal 5-Phosphate which this one has.

[pubmed.ncbi.nlm.nih.gov]

"Pyridoxine induced cell death in a concentration-dependent way in SHSY5Y cells."

"In conclusion, the present study indicates that the neuropathy observed after taking a relatively high dose of vitamin B6 supplements is due to pyridoxine. The inactive form pyridoxine competitively inhibits the active pyridoxal-5'-phosphate. Consequently, symptoms of vitamin B6 supplementation are similar to those of vitamin B6 deficiency."



Edited 1 time(s). Last edit at 05/15/2021 10:00AM by NotLyingAboutMyAfib.

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NotLyingAboutMyAfib


I spent some time researching the best multi-B supplement and take 1 of these a day (unaffiliated) (Consumer labs doesn't even note this!!!)

[www.amazon.com]

."

so how did you come to this conclusion? I have a functional med doc appt in the morning. A couple things I need to discuss but one is that I went in afib during her last recommendations and one thing I had started was a tiny tiny bit of B-12. I do like Thorne supplement-s I usually just do one thing at a time.. but I am curious more info on this. Because I do have a deficiency--

Lilly - since my 2018 afib episode, my EKGs are "abnormal". Everytime I question it I'm told it's due to the way my heart is positioned ("left axis" something). I'm being told "don't worry, we'll let you know if it's a concern". It's almost impossible for me to not worry! I've had 3 documented episodes of afib (2006,2018, 2021 and converted back naturally after few hours). Ectopics (palpitations, skipped beats, PACs, PVCs, whatever they call them) since I was 16 (52yr ago) and as bad as these feel I'm still being told it's nothing they're concerned about. I love the responses you got "you're going to be ok"! It makes living with this so much better mentally. I was on aspirin daily until second afib, then given Eliquis. I was told to take B12 due to deficiency 2wks before my recent afib rattle. I am going to stop and see what happens. It's interesting to research to find B12 deficiency can cause afib, but then read posts from patients saying B12 was a trigger for them

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Muntz
I was told to take B12 due to deficiency 2wks before my recent afib rattle. I am going to stop and see what happens. It's interesting to research to find B12 deficiency can cause afib, but then read posts from patients saying B12 was a trigger for them

Why would you stop if you have a documented deficiency? People wrongly identify AF triggers all the time. If everything I've heard people label as triggers really are, then pretty much every substance and every activity known to man is a trigger.

Carey - thanks, that's something to rethink about and I'll be discussing with my doc to determine if b12 was a trigger for me since my episode came when I started taking it. The b12 standard range is 123-730 and mine was 200. So I'm within range but doc felt it was a "low normal". I'm finding out the rule is everybody and every condition is different! What works or doesn't work is on individual cases. An EP told me to take Magnesium for my palpitations but didn't help at all. They're just as bad taking it. But I do value the posts, information, and opinions shared!

What you shouldn't expect is quick results from supplements. It takes months of supplementation to correct a magnesium deficiency, and I don't know but the same might be true of a B12 deficiency (or low normal). I'm just super skeptical that B12 is a trigger.

Carey- thanks again! I'll try to keep open mind on b12. I was thinking because they happened about the same time.
But you're correct, that doesn't always mean they're related. About magnesium, I have no deficiency. My EP recommended it 2yrs ago for the palps and still taking. So again, just because it works on some doesn't mean it would work for me. Back to final revelation...
everyone is different, each case is different! Take care.