Ectopics

Afib is new to me, as my first couple of big episodes a few weeks ago landed me in the ER. I felt like I had drunk 50 cups of double espresso. Now I am an afibber on beta blockers and blood thinners. Since the initial problems, I have had a couple of milder episodes, and these have stopped, trickling off to a couple of ectopics or skipped beats on occasion. Now I'm worried. Are the ectopics just a big episode of afib trying to break through? I'm in unfamiliar territory here, but what is the difference between ectopics, palpitations, and afib? Isn't afib mostly about elevated heartbeat? How does a skipped beat or irregularity figure in here? And, could these symptoms be a side effect of beta blockers? My heart rate is now ridiculously low (45-50). So, my heart just feels heavy and weird. I'm super self-conscious of my heart. I live in fear of another attack of afib, now that I know about the elevated stroke risk. Can members of the forum relate to these feelings or maybe clarify things a bit for me?

Hey Mel. Sorry your here. Ok wow. Afib is not always fast but almost always irregular. Usually fast Mine would be 135-155 prior to 2012 ablation. What beta blocker? Metropolol? How many mgs? It will not keep you outa afib but can keep rate down during an episode. PVCs are not afib but come sometimes with this condition. My pvc s ive always linked to anxiety and emotions. Take magnesium throughout the day say 100 mg 4 times to start. No alcohol! Find an EP in your area. Do research. You’re anticoagulated so try and relax. 5/5 of eliquis? No msg and watch indigestion. Dont sleep on left side. Thats a start. Better will chime in but ive had afib since 2005. 3 ablations. 11 cardioversions. Many meds that rarely work. Im 68 in vg physical condition but………youve got alota company!

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Mel-O
Can members of the forum relate to these feelings or maybe clarify things a bit for me?

Your two big risks with afib are stroke and cardiomyopathy (heart failure). Your meds address both. The blood thinners address the stroke risk. The docs use a scoring tool, CHA2DS2-VASc to get a better handle on stroke risk. It is described here: [en.wikipedia.org] Usually the 1 point for female sex is not counted.

The beta blocker addresses the cardiomyopathy risk. What you don't want is a heart rate in afib that averages above 100 BPM for long periods (obviously will increase when exerting yourself). The beta blocker is used for rate control. If the heart rate remains elevated for long periods (days & weeks), the heart will enlarge and what is called the ejection fraction (EF) will decrease. The EF is the % of blood ejected from the ventricles on each beat. Normal is something like 55-70%. The EF is determined on a heart ultrasound called an echocardiogram.

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ectopics, palpitations, and afib

Palpitations can be anything that is not normal rhythm. Ectopics are usually premature atrial or ventricular contractions (PAC's or PVC's). They are generally benign, though sometimes a PAC can kick off afib. In afib the atria are beating at ~300 BPM. The nerve that carries the signal from the atria to the ventricles is called the AV node. It usually puts a slight delay in the signal and forward's it on. The ventricles don't want to beat at 300 BPM, so the AV node blocks some of the signals randomly. Hence the ventricular rate in afib is very variable. If your graph heart rate vs time during afib, it can look like a seismogram during an earthquake. Some people can get lots of PAC's or PVC's (1000's/day)s and not have afib (even those who are prone to afib).

You could talk to your doc about adjusting the dose of the BB. You'd like to have an afib resting heart rate < 100 BPM, but not have your rate in normal rhythm be too low. BB's can make people feel sluggish. Other meds can also be used as rate control, so you may want to discuss this with your doc. If you are in afib very infrequently, then maybe only take the BB when you are out of rhythm.

If your heart is structurally sound, a possible option to discuss with your doc is a rhythm med to be taken on-demand when in afib to convert you back to normal rhythm relatively quickly. More info is here: [www.afibbers.org]



Edited 1 time(s). Last edit at 08/27/2021 06:16AM by GeorgeN.

Thanks! I have a lot to learn.