Persistent asymptomatic afib

I was first diagnosed with afib about 10 years ago. But it never bothered me and I ignored it. As the years progressed, I noticed it less and less. About 4 months ago I went in for a cardio check up and they told me that I was in afib, to my surprise. They put a halter monitor on me and it showed me in constant afib with bpm's from 50 to over 200. They put me on verapamil. I've been on it for a month now and I've been using a Kardia device several times a day to monitor. It always shows me in afib but my bpm's are usually below 100. So, it doesn't seem to be helping too much.
I'm 62. BMI of 21. Don't drink or smoke and get a lot of exercise. I don't have any symptoms. Sleep great, no shortness of breath....nothing. any advice? Different meds? Ablation?

Thanks

and no anti-coagulant, Peter? Surprised you don't have any symptoms or is that no symptoms when in AF @ under 100?
As for advise, there is a lot on this site from very smart people.

Hi Joe, welcome to the forum. Sorry you found the need to look us up.

Just because you don't experience symptoms doesn't mean much. That's pretty common with people who are in longstanding persistent afib as you apparently are. The thing is, afib presents two dangers to you. The first one is stroke risk. You said nothing about being prescribed an anticoagulant. I hope that was just an omission on your part and you are taking one. If you're not, you need to be on the phone to your doctor tomorrow morning asking why not.

The second danger is your heart rate. You said this:

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They put a halter monitor on me and it showed me in constant afib with bpm's from 50 to over 200. They put me on verapamil. I've been on it for a month now and I've been using a Kardia device several times a day to monitor. It always shows me in afib but my bpm's are usually below 100.

What do you mean by "usually below 100?" If you spend much time at all above 100, and sure as hell above anything approaching 200, then your rate isn't well controlled by the verapamil. Allowing a heart rate over 100 to continue for months can lead to heart enlargement and eventually heart failure.

What sort of doctor is treating you? Are they an electrophysiologist (EP), a general cardiologist, or a primary care doc?

Thank you for the prompt response. Its a general cardiologist and I asked about why I wasn't prescribed a blood thinner and they said I have a "chads2 score of zero" "So there's no need". My resting heart rate is in the 60 to 100 range but gets much higher during exercise and for quite a while after exercise. I think this is about the same as the the halter monitor data I got before the verapamil. I'm thinking that a month should be ample time for this medication to be working?

I kind of figured you were going to say a general cardiologist. I recommend that you see an electrophysiologist (EP) instead. An EP is a cardiologist who specializes in heart rhythm disturbances and the electrical conduction system of your heart. Think of them as the electricians of the cardiology world while general cardiologists are the plumbers. You have an electrical problem, not a plumbing problem, so an EP would be better qualified to treat you. For example, verapamil is rarely used as the first drug of choice in afib and I doubt an EP would keep you on it. In fact, if your resting heart rate without it is consistently under 100, then it's questionable why you need it at all. Your heart rate going over 100 during/after exercise is perfectly normal. Not sure what you mean by it remaining elevated for quite a while afterward. How long is "quite a while" and how high does it go? After all, you did say the Holter monitor showed rates over 200. Was that just an occasional short burst of 200+ for a few seconds or was it sustained?

The holter monitor was prior to taking verapamil. They told me my heart rate exceeded 200 during very hard physical exercise, but got as low as 50 at rest. That is all the detail they gave me. I started using the Kardia at the same time I started taking the verapamil. About a month ago. This morning, I've used the Kardia 6 times in the last 3 hours and my rate is consistently 60 o 80. But yesterday. Two hours after a strenuous bike ride, I was getting readings in the 100 to 130 range. I have not used the Kardia during or immediately after strenuous exercise, so I don't know how high its getting. It sounds like I need to consult an EP .

I noticed the same thing about extended high heart rates after doing something strenuous when i had my 3 to 48 hour bouts before chewing Propafenone to get my afib duration down to about an hour and then finally got froze + burned into NSR bliss.

If i were you i would get an ablation. Your holter already confirmed it so get that EP Carey mentioned and get the ball rolling.

I delayed my Ablations (1st cyro.....failed because i had miss shaped PV's so the balloon could only do about 60% + a 5th PV also.....2nd RF finished it off perfectly) and looking back it was 1 of the worst things i ever decided to do was to wait.

With your heart rate really high at times i say the sooner the better.

You will not believe the feeling of living in a world of NSR again both for your body + MIND ALSO....most take it for granted but until people have gone through this afib hell....NSR=heaven.

Everyday/hour you go through this your Q. of life is diminished not to mention the strain on your heart in those extended high heart rate periods so Monday morning 1st thing GET ON IT.

Hi.
I've read the main goal of ablation is to eliminate symptoms and improve QoL. The secondary goal is to acheive NSR and decrease the future risk of stroke, heart failure, etc. I'm 68 and drifting toward persistent afib with no symptoms and HR in 70s and 80s. I'm thinking about ablations to decrease risk of future stroke, heart failure, etc. But I'm afraid of ablations causing symptoms and not eliminating the afib.
Does anyone know if most asymptomatic fibbers become symptomatic eventually?

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NealM
Hi.
I've read the main goal of ablation is to eliminate symptoms and improve QoL. The secondary goal is to acheive NSR and decrease the future risk of stroke, heart failure, etc. I'm 68 and drifting toward persistent afib with no symptoms and HR in 70s and 80s. I'm thinking about ablations to decrease risk of future stroke, heart failure, etc. But I'm afraid of ablations causing symptoms and not eliminating the afib.
Does anyone know if most asymptomatic fibbers become symptomatic eventually?

No, they usually don't. The way you reduce stroke risk is by taking anticoagulants. Are you on one now? Go here and calculate your CHADS-Vasc score. If it's 2 or higher, you need to be. If it's 1, you need to talk to your doctor about it.

The way you avoid heart failure by taking a beta blocker or diltiazem to limit your heart rate, but it doesn't sound like you need to worry about that if your heart rate stays under 100 when you're in afib.

There are many people out there living perfectly normal lives who have persistent afib. Properly managed with anticoagulants and rate control, afib does not reduce life span or QoL.

PS- I really had to search to find your post because you appended it to a thread that's months old. It would be better if you started a new thread to discuss your issues otherwise your posts will be hard for people to find and respond to.