Long term persistent, asymptomatic, until now!

Hello. Brand new to the Phorum. I'm 73. For several years I experienced symptoms that I put down to being dehydrated. Hmm. Episodes became more frequent and eventually I was diagnosed with AFIB. Unfortunately by that time I was in persistent AFIB. The diagnosis was 18 months ago. For a year I used the Kardia 6 line and wondered day after day why I was using it since it always said the same thing - you have AFIB. I passed it on to a friend whose doctors are trying to determine her heart rhythm problem. So,immediately after diagnosis I stopped all alcohol, all caffeine :-(( , and lost a bunch of weight. I've been asymptotic. Two months ago I had a mild episode. No big deal. I just sat down and waited till the fog lifted. Yesterday as I was driving to the market I fortunately was able to safely pull off the road because I was very lightheaded, close to passing out, sweating profusely, and nauseated. After 15 minutes most symptoms receded and I was able to continue on. Returned home and felt nauseated and wiped out for the rest of the day. This event has left me very concerned about driving because there was nothing I can tie the episode to, nothing from the day before or earlier in the morning - just out of the blue. I see a cardio who did a stress echo back when I was diagnosed and in all other ways my heart is healthy, e.g., good fraction, no atherosclerosis (thanks to BP med, statin) . My pulse is always 70-80. Don't know what it was when this happened yesterday. When I asked what I should do about the AFIB his response was "live with it". Hmm. So that is what I've done. Eliquis $$$!!! twice daily and life goes on. I do not know what he will suggest when I tell him about yesterday's episode. Have not seen nor been referred to an EP. There are none here where I live, but some up in Tucson. From what I read it seems like cardioversion would be basically useless for me; ablation(s) of limited temporary use; Maze IV might do the trick(?). Meanwhile, I am very concerned about driving. If I had been on Interstate 10 in Tucson I probably would have had an accident - a bad one at 65mph. Anyone have some wisdom to share? Thanks for reading this.
David

I would be concerned that you have something more than afib going on, but it sounds like your cardiologist has chalked it up as afib and isn't going to investigate further. A simple thing for them to do, for example, would be to have you wear a monitor for a month to see what's actually going on when you experience these symptoms. But since they don't seem interested in finding out what's going on, buy a new Kardia. You don't need the 6L. Just buy the basic model and find out for yourself what this is.

But whatever it is, if you hear "just live with it" from a cardiologist, you need a new cardiologist. Frankly, that's a lazy, uncaring answer based on what he learned in med school 30 years ago.

You need a new Cardiologist and an EP.
I’m gobsmacked that with all of the information and research available a Cardiologist is so uninterested in your care he says “live with it”
I’d be doing as Carey suggests and finding yourself a couple of top notch people who will give you the care you are entitled to.
I’m speaking from experience, believe me , after having listened to very poor advice for a very long time.

Quote
diesel
From what I read it seems like cardioversion would be basically useless for me; ablation(s) of limited temporary use; Maze IV might do the trick(?).

Hi David,

Ablation, with a top EP, such as Andrea Natale is your best bet. Natale's home base is Austin, TX, but he spends a week in California, too. A few days at Scripps in La Jolla and a few more at Los Robles Hospital, in the northern LA area. Stay away from a Maze! See Carey's comment from a few days ago here.

Many here will back up my comment.

regarding your assumption that when you had "a stress echo" approximately 18 months ago it showed that, except for your diagnosis of A-fib, that in "all other ways my heart is healthy, e.g., good fraction, no atherosclerosis (thanks to BP med, statin) . My pulse is always 70-80."

Keep in mind: "...no test is 100 percent accurate. A stress test can be wrong for a variety of reasons. For example, a nuclear stress test may be inaccurate if someone has severe blockages in all three main coronary arteries. The test looks for differences in blood flow between areas of the heart. If the entire heart has reduced blood flow, no one area of the heart will look abnormal compared to the rest. If you’re having chest pain or shortness of breath following a normal stress test, continue to seek medical evaluation. " - Mayo Clinic Q and A: Chest pain despite normal stress test

When I recently presented with A-fib after being in remission for 3 1/2 years one cardiologist I saw looked at my 3 1/2 year old heart ultrasound and nuclear stress tests that showed a normal healthy heart and decided there was no need to take another look. I decided on a second opinion. The next cardiologist I saw a few days later repeated both tests, became alarmed, and scheduled me for a coronary angiogram, a more definitive examination, tomorrow. He said if the angiogram shows there actually is coronary blockage, that could be a significant contributor to the recurrence of my A-Fib.

FWIW
"Work with your doctor to keep investigating until the source of the symptoms is identified." Mayo Clinic Q and A: Chest pain despite normal stress test

"a normal stress test often causes patients with substantial cardiac risk to forgo treatment and have a false sense of security" - "Is Your Stress Test the Wrong Test?"



Edited 1 time(s). Last edit at 12/16/2021 04:45PM by David_L.