Is high pulse (e.g. 120) always AFIB?

Every week or so I experience a pulse around 120 that can last several hours and was diagnosed with AFIB based on an EKG. I bought a Kardiomoble and look at my EKG which shows the high pulse with a repeated waveform with a clear R waves but so close together it is hard to distinguish a P wave between them. I don't know how anyone can tell I am experiencing AFIB, not just a high pulse. I have no indication of AFIB without the high pulse (had the tests and no structural heart issues) so am trying to understand if the underlying issue is the high pulse. A really weird thing, I have been taking a B12 energy drink with 100mg caffeine but very low calorie, a couple times a day for years. I thought this was the issue and skipped it for a week and then had a high pulse event. Felt lousy and remembered feeling that way and the energy drink helped in the past. I took the energy drink and felt great and my pulse dropped from 120 to below 60 in about a half hour. Make no sense?

Makes no sense because it's probably pure coincidence.

A high heart rate isn't always afib by any means. There are other atrial arrhythmias. The most likely culprit would be afib's evil cousin, atrial flutter. It's characterized (usually) by a regular, rapid heart rate. A rate of 150 is very common, but so is 120. There are others such as SVT and atrial tachycardia, but my bet would be what you're experiencing is flutter. A Kardia can't diagnose flutter, but you could easily stop in a walk-in clinic and they can do a full 12-lead ECG. Whereas with afib the P waves are absent, what you'll see with flutter is multiple P waves between each beat. When the clinic tells you that you should go to the ER because that's what they're required to advise, just smile and decline.

Are you seeing an EP? Are you on any medications for afib?

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kenn_green
... I don't know how anyone can tell I am experiencing AFIB, not just a high pulse. I have no indication of AFIB without the high pulse (had the tests and no structural heart issues) so am trying to understand if the underlying issue is the high pulse. ...

There is a way to do this, but is must be done in a lab or ER, and it requires the administration, under supervision, with an ECG underway, of a drug called adenosine. Adenosine slows the heart drastically, but generally won't disrupt the current rhythm or arrhythmia. By slowing the heart, the ECG, which is still reading real-time, can show much more discrete information in the recording, and with that printout the attending physician can easily see what's really going on. Happened to me this past New Year's Eve.

I've had adenosine a few times. The only thing I can say about it is you'll know what cardiac arrest feels like after you've had it. It only lasts a few seconds, but it's not a pleasant few seconds.

Most atrial arrhythmias can be diagnosed from an ECG alone. The adenosine is usually reserved for when they're trying to distinguish between AVNRT and AVRT (two types of SVT).

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kenn_green
Every week or so I experience a pulse around 120 that can last several hours and was diagnosed with AFIB based on an EKG. I bought a Kardiomoble and look at my EKG which shows the high pulse with a repeated waveform with a clear R waves but so close together it is hard to distinguish a P wave between them. I don't know how anyone can tell I am experiencing AFIB, not just a high pulse.

You can take your ECG and do what I did for a member in this post: [www.afibbers.org] A trained eye doesn't need to do this, but doing this for 20 beats or so will give you a good clue and is easier for an untrained person to see.

Afib is irregularly irregular. If you are seeing regularity, as in my linked post. It isn't afib. This won't tell you what it is, but it isn't afib. If you scroll up a bit in this thread, you can see examples I've posted showing variability that is not afib.

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Carey
I've had adenosine a few times. The only thing I can say about it is you'll know what cardiac arrest feels like after you've had it. It only lasts a few seconds, but it's not a pleasant few seconds.

Most atrial arrhythmias can be diagnosed from an ECG alone. The adenosine is usually reserved for when they're trying to distinguish between AVNRT and AVRT (two types of SVT).

It gave me a type 2 MI 12-26-20. The ER dr insisted. I begged and refused repeatedly. Dr N’s NP was on the phone telling him to not do it. He refused her request stating he was a MD and she only my NP. He did it not once but three times in a row and I was diagnosed by the chief of cardiology that I suffered a type 2 MI. I wear a bracelet now stating not to administer. I later found out the two RNs in the room reported him for his actions and he no longer has attending at the hospital.

Carey is right. Felt like a cardiac arrest.

The cardiologist prescribed 25mg Metoprolol Tartrate and 20mg Xarelto.

I don't think the Metoprolol Tartrate is doing anything good, the episodes seem about as often and long as before. I'd like to drop it. I have a very slow heart, usually in the 50, and while relaxing waiting for one of the AFIB tests kept setting off an alarm in the 40's. I'm 72 and have done 25-30min (250 to 300 calories) of cardio and then weights, 3 times a week for years.

I suspect the AFIB is from poor sleep. My wife is sure I have sleep apnea and a sleep study just confirmed that, and am scheduled to see a sleep Dr, but no appointments till November. In the past it seemed that nights when I didn't sleep well, my heart took off the next day.

I read that AFIB, sleep apnea, and hypertension can all be from agent orange and I was in Vietnam in 1971.

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kenn_green
I suspect the AFIB is from poor sleep. My wife is sure I have sleep apnea and a sleep study just confirmed that, and am scheduled to see a sleep Dr, but no appointments till November.

Have you tried taping your mouth during sleep? It can, in many mild to moderate sleep apnea cases, dramatically reduce the number of events. In this post there are three heart rate vs time graphs. The upper is overnight. The first third is without tape, the last two thirds (ish) is with tape. The second graph is a zoomed view without tape. You can see apnea patterns in beat to beat heart rate data. You can see the patterns here. The third graph is with tape and notice how much smoother it is. This is the tape I've used for many years. 200 strips for $13. You can also use 1" 3M Micropore tape, available at most pharmacies. "Breath" author, James Nestor, uses a small piece vertically. I use the whole strip horizontally. Search on Nestor and mouth or sleep tape & you should find a number of hits. Ask if you have more questions about this. With any of the tapes, you can fold over a wee bit of the tape at one end to make it easier to remove. I have a mustache, and I just put it under the hair, across my top lip. You can also put the tape on during the day for a bit, initially, to get use to it. Practicing nasal breathing all day (I do it even during intense exercise) can also help retrain your breathing patterns for nighttime.

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kenn_green
I don't think the Metoprolol Tartrate is doing anything good, the episodes seem about as often and long as before. I'd like to drop it. I have a very slow heart, usually in the 50, and while relaxing waiting for one of the AFIB tests kept setting off an alarm in the 40's. I'm 72 and have done 25-30min (250 to 300 calories) of cardio and then weights, 3 times a week for years.

I read that AFIB, sleep apnea, and hypertension can all be from agent orange and I was in Vietnam in 1971.

Does the Metoprolol Tartrate help with your blood pressure? If so you should keep it.

While exercise is wonderful, for some, it can lead to afib. Especially with a delayed vagal (parasympathetic) trigger. It did for me. I did figure out a way to maintain great fitness, but not have the exercise be a trigger. More in this post.

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GeorgeN

...

While exercise is wonderful, for some, it can lead to afib. Especially with a delayed vagal (parasympathetic) trigger. It did for me. I did figure out a way to maintain great fitness, but not have the exercise be a trigger. More in this post.

...and, unfortunately, this superb sword has twinned edges. The other edge is that, the fitter the heart, the less inclined it is, at rest, to beat quickly. So, without the meto, your heart wants to drop to the high 40's-ish, but it might be pushed down by the drug. T'is the ol' Catch 22.

My cardiologist was adamant that I continue to exercise as much as I could. Unfortunately, as the months went by, even laughing during a sitcom would set me off...which in turn was most off-putting. Made exercise essentially impossible. And, my new girth shows as much.